Provider Demographics
NPI:1750943809
Name:SPECIALE, BRIANNE (RMFTI)
Entity type:Individual
Prefix:
First Name:BRIANNE
Middle Name:
Last Name:SPECIALE
Suffix:
Gender:F
Credentials:RMFTI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 N NEW RIVER DR E APT 1730
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33301-1092
Mailing Address - Country:US
Mailing Address - Phone:818-625-2141
Mailing Address - Fax:
Practice Address - Street 1:215 N NEW RIVER DR E APT 1730
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33301-1092
Practice Address - Country:US
Practice Address - Phone:818-625-2141
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-28
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL106H00000X
FLMT4327106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist