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Individual

BRIANNE J SOUTH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRC

Contact information

Practice address
32 WAVERLY AVE, EAST ROCKAWAY, NY 11518-1339
(516) 641-1369
Mailing address
32 WAVERLY AVE, EAST ROCKAWAY, NY 11518-1339
(516) 641-1369

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
A21278
NC
225C00000X
Rehabilitation Counselor
Primary
478095
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
A21278
NORTH CAROLINA BOARD OF LICENSED CLINICAL MENTAL HEALTH COUNSELOR
NC
Enumeration date
03/17/2025
Last updated
04/21/2025
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