Provider Demographics
NPI:1023747516
Name:MITCHELL, BRIANNA (DPT)
Entity type:Individual
Prefix:
First Name:BRIANNA
Middle Name:
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:BRIANNA
Other - Middle Name:
Other - Last Name:HEYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:16 MAYBROOK RD STE D
Mailing Address - Street 2:
Mailing Address - City:CAMPBELL HALL
Mailing Address - State:NY
Mailing Address - Zip Code:10916-2741
Mailing Address - Country:US
Mailing Address - Phone:845-636-4344
Mailing Address - Fax:
Practice Address - Street 1:3700 NW CARY PKWY STE 110
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27513-8446
Practice Address - Country:US
Practice Address - Phone:919-319-3649
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-09
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP21368225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist