Provider Demographics
NPI:1972074490
Name:MCALLISTER, BRIA S
Entity Type:Individual
Prefix:
First Name:BRIA
Middle Name:S
Last Name:MCALLISTER
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 1:120 ACKLINS CIR APT 104
Mailing Address - Street 2:
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32119-9761
Mailing Address - Country:US
Mailing Address - Phone:229-457-8668
Mailing Address - Fax:
Practice Address - Street 1:120 ACKLINS CIR APT 104
Practice Address - Street 2:
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32119-9761
Practice Address - Country:US
Practice Address - Phone:229-457-8668
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-10
Last Update Date:2018-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health