Provider Demographics
NPI:1740566009
Name:GAYNOR, BRIANNA (PSYD)
Entity Type:Individual
Prefix:
First Name:BRIANNA
Middle Name:
Last Name:GAYNOR
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3580 OLD MILTON PKWY
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30005-4465
Mailing Address - Country:US
Mailing Address - Phone:678-667-3565
Mailing Address - Fax:404-443-0926
Practice Address - Street 1:3580 OLD MILTON PKWY
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30005-4465
Practice Address - Country:US
Practice Address - Phone:678-667-3565
Practice Address - Fax:404-443-0926
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-31
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPSY003462103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical