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Individual

BRIEANNE BEAUJOLAIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
495 E MAIN ST, COLUMBUS, OH 43215-5349
(614) 355-8695
(614) 355-8620
Mailing address
DEPT 781625, DETROIT, MI 48278-1625
(614) 355-8004
(614) 355-2220

Taxonomy

Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
S.1510395-TRNE
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2846675
OH
Enumeration date
10/12/2016
Last updated
10/12/2016
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