Provider Demographics
NPI:1356180152
Name:ANDERSON, BRIA
Entity type:Individual
Prefix:
First Name:BRIA
Middle Name:
Last Name:ANDERSON
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 1:8251 BAYOU FOUNTAIN AVE # 3
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70820-8640
Mailing Address - Country:US
Mailing Address - Phone:225-831-0203
Mailing Address - Fax:
Practice Address - Street 1:8251 BAYOU FOUNTAIN AVE # 3
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70820-8640
Practice Address - Country:US
Practice Address - Phone:225-831-0203
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-21
Last Update Date:2024-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst