Provider Demographics
NPI:1053992206
Name:DAVIS, BRIANNA (LCSW)
Entity type:Individual
Prefix:
First Name:BRIANNA
Middle Name:
Last Name:DAVIS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2825 E COTTONWOOD PKWY STE 500
Mailing Address - Street 2:
Mailing Address - City:COTTONWOOD HEIGHTS
Mailing Address - State:UT
Mailing Address - Zip Code:84121-7060
Mailing Address - Country:US
Mailing Address - Phone:801-610-9249
Mailing Address - Fax:
Practice Address - Street 1:2825 E COTTONWOOD PKWY STE 500
Practice Address - Street 2:
Practice Address - City:COTTONWOOD HEIGHTS
Practice Address - State:UT
Practice Address - Zip Code:84121-7060
Practice Address - Country:US
Practice Address - Phone:801-610-9249
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-19
Last Update Date:2024-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8294087-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical