Provider Demographics
NPI:1013763051
Name:RIOUS, BRIANNA NICOLE RUTH
Entity type:Individual
Prefix:
First Name:BRIANNA
Middle Name:NICOLE RUTH
Last Name:RIOUS
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 1:28390 LOCKDALE ST APT 309
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48034-1919
Mailing Address - Country:US
Mailing Address - Phone:313-433-1280
Mailing Address - Fax:
Practice Address - Street 1:28390 LOCKDALE ST APT 309
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48034-1919
Practice Address - Country:US
Practice Address - Phone:313-433-1280
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-29
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist