Individual
BRIANNA NICOLE JEFFERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3375 SPRING HILL PKWY SE APT 1034, SMYRNA, GA 30080-6837
(256) 663-9172
Mailing address
8259 WICKER AVE, SAINT JOHN, IN 46373-8878
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
AT003789
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4046518681
—
GA
Enumeration date
12/16/2020
Last updated
12/16/2020
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