Provider Demographics
NPI:1245081033
Name:JARRETT, BRIEANNA
Entity type:Individual
Prefix:
First Name:BRIEANNA
Middle Name:
Last Name:JARRETT
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 1:35833 FARRAGUT AVE
Mailing Address - Street 2:
Mailing Address - City:WESTLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48186-4209
Mailing Address - Country:US
Mailing Address - Phone:810-580-9038
Mailing Address - Fax:
Practice Address - Street 1:35833 FARRAGUT AVE
Practice Address - Street 2:
Practice Address - City:WESTLAND
Practice Address - State:MI
Practice Address - Zip Code:48186-4209
Practice Address - Country:US
Practice Address - Phone:810-580-9038
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-29
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician