Provider Demographics
NPI:1821757295
Name:WEST, BREANNA MORRIS
Entity Type:Individual
Prefix:MRS
First Name:BREANNA
Middle Name:MORRIS
Last Name:WEST
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1192 PARKS RD
Mailing Address - Street 2:
Mailing Address - City:LINCOLNTON
Mailing Address - State:GA
Mailing Address - Zip Code:30817
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1192 PARKS RD
Practice Address - Street 2:
Practice Address - City:LINCOLNTON
Practice Address - State:GA
Practice Address - Zip Code:30817
Practice Address - Country:US
Practice Address - Phone:706-816-9689
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-14
Last Update Date:2021-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool