Provider Demographics
NPI:1134608912
Name:DEPINA, BRIANNE HOPE
Entity type:Individual
Prefix:
First Name:BRIANNE
Middle Name:HOPE
Last Name:DEPINA
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 1:785 VERNON ST
Mailing Address - Street 2:
Mailing Address - City:BRIDGEWATER
Mailing Address - State:MA
Mailing Address - Zip Code:02324-3572
Mailing Address - Country:US
Mailing Address - Phone:339-832-9529
Mailing Address - Fax:
Practice Address - Street 1:785 VERNON ST
Practice Address - Street 2:
Practice Address - City:BRIDGEWATER
Practice Address - State:MA
Practice Address - Zip Code:02324-3572
Practice Address - Country:US
Practice Address - Phone:339-832-9529
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-12
Last Update Date:2018-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health