Provider Demographics
NPI:1144921362
Name:HAYES-JOHNSON, BRIANA
Entity type:Individual
Prefix:
First Name:BRIANA
Middle Name:
Last Name:HAYES-JOHNSON
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 1:12268 MOONDANCE PL
Mailing Address - Street 2:
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20601-4709
Mailing Address - Country:US
Mailing Address - Phone:301-335-4066
Mailing Address - Fax:
Practice Address - Street 1:12268 MOONDANCE PL
Practice Address - Street 2:
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20601-4709
Practice Address - Country:US
Practice Address - Phone:301-335-4066
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-14
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator