Provider Demographics
NPI:1922564327
Name:CRAIGE, BRIANA A
Entity Type:Individual
Prefix:
First Name:BRIANA
Middle Name:A
Last Name:CRAIGE
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 1:2520 BERT KOUNS INDUSTRIAL LOOP STE 100
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71118-3130
Mailing Address - Country:US
Mailing Address - Phone:318-212-5072
Mailing Address - Fax:
Practice Address - Street 1:2520 BERT KOUNS INDUSTRIAL LOOP STE 100
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71118-3130
Practice Address - Country:US
Practice Address - Phone:318-212-5072
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-11
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No171M00000XOther Service ProvidersCase Manager/Care Coordinator