Provider Demographics
NPI:1922883727
Name:POINDEXTER, BRIONNA ALEXIS
Entity Type:Individual
Prefix:
First Name:BRIONNA
Middle Name:ALEXIS
Last Name:POINDEXTER
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 1:4330 MEADOW MILLS RD
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-8204
Mailing Address - Country:US
Mailing Address - Phone:240-374-2587
Mailing Address - Fax:
Practice Address - Street 1:4330 MEADOW MILLS RD
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-8204
Practice Address - Country:US
Practice Address - Phone:240-374-2587
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-29
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician