Provider Demographics
NPI:1881942936
Name:BRANNER, TIANA CAROLYNN LAFAY (MSW)
Entity type:Individual
Prefix:
First Name:TIANA
Middle Name:CAROLYNN LAFAY
Last Name:BRANNER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6848 STIRLING RD
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33024-1842
Mailing Address - Country:US
Mailing Address - Phone:954-362-0104
Mailing Address - Fax:
Practice Address - Street 1:6848 STIRLING RD
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33024-1842
Practice Address - Country:US
Practice Address - Phone:954-362-0104
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-21
Last Update Date:2012-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker