Provider Demographics
NPI:1518207349
Name:BRASS, QIANA DANIELLE
Entity type:Individual
Prefix:MRS
First Name:QIANA
Middle Name:DANIELLE
Last Name:BRASS
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 1:1836 W NELSON AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89032-3754
Mailing Address - Country:US
Mailing Address - Phone:702-610-6881
Mailing Address - Fax:
Practice Address - Street 1:1836 W NELSON AVE
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89032-3754
Practice Address - Country:US
Practice Address - Phone:702-610-6881
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-14
Last Update Date:2013-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker