Provider Demographics
NPI:1336014299
Name:FRACTION, BREYON
Entity type:Individual
Prefix:
First Name:BREYON
Middle Name:
Last Name:FRACTION
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1454 MEXICO WAY NE
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24012-6476
Mailing Address - Country:US
Mailing Address - Phone:434-533-1088
Mailing Address - Fax:434-664-1177
Practice Address - Street 1:316 BROOK PARK PL STE A1
Practice Address - Street 2:
Practice Address - City:FOREST
Practice Address - State:VA
Practice Address - Zip Code:24551-2766
Practice Address - Country:US
Practice Address - Phone:434-533-1088
Practice Address - Fax:434-664-1177
Is Sole Proprietor?:No
Enumeration Date:2025-10-09
Last Update Date:2025-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor