Provider Demographics
NPI:1255017133
Name:FLYNN, BRIA MARSHAY
Entity type:Individual
Prefix:
First Name:BRIA
Middle Name:MARSHAY
Last Name:FLYNN
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 1:59 PENN BLVD
Mailing Address - Street 2:
Mailing Address - City:EAST LANSDOWNE
Mailing Address - State:PA
Mailing Address - Zip Code:19050
Mailing Address - Country:US
Mailing Address - Phone:267-283-8799
Mailing Address - Fax:
Practice Address - Street 1:59 PENN BLVD
Practice Address - Street 2:
Practice Address - City:EAST LANSDOWNE
Practice Address - State:PA
Practice Address - Zip Code:19050
Practice Address - Country:US
Practice Address - Phone:267-283-8799
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-26
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician