Provider Demographics
NPI:1790596716
Name:SUZANNE G. BRIANS
Entity type:Organization
Organization Name:SUZANNE G. BRIANS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:G
Authorized Official - Last Name:BRIANS
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:430-288-1629
Mailing Address - Street 1:1820 SHILOH RD STE 1205
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75703-2458
Mailing Address - Country:US
Mailing Address - Phone:430-288-1629
Mailing Address - Fax:903-747-8024
Practice Address - Street 1:1820 SHILOH RD STE 1205
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75703-2458
Practice Address - Country:US
Practice Address - Phone:430-288-1629
Practice Address - Fax:903-747-8024
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-17
Last Update Date:2025-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty