Provider Demographics
NPI:1780423897
Name:FORDE, BRIANA (BS)
Entity type:Individual
Prefix:
First Name:BRIANA
Middle Name:
Last Name:FORDE
Suffix:
Gender:X
Credentials:BS
Other - Prefix:
Other - First Name:BRIE
Other - Middle Name:
Other - Last Name:FORDE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:BS
Mailing Address - Street 1:4310 HIDDEN MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34746-2306
Mailing Address - Country:US
Mailing Address - Phone:321-805-2085
Mailing Address - Fax:
Practice Address - Street 1:7522 WILES RD # B213
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33067-2062
Practice Address - Country:US
Practice Address - Phone:561-866-3056
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-20
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health