Provider Demographics
NPI:1356968846
Name:BASS, BRIANA MARIE
Entity type:Individual
Prefix:
First Name:BRIANA
Middle Name:MARIE
Last Name:BASS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:BRIANA
Other - Middle Name:MARIE
Other - Last Name:PRISER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:412 BRIERLY LN
Mailing Address - Street 2:
Mailing Address - City:WEST MIFFLIN
Mailing Address - State:PA
Mailing Address - Zip Code:15122-1210
Mailing Address - Country:US
Mailing Address - Phone:225-270-4619
Mailing Address - Fax:
Practice Address - Street 1:241 MAPLE AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15218-1523
Practice Address - Country:US
Practice Address - Phone:225-270-4619
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-30
Last Update Date:2020-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician