Provider Demographics
NPI:1679253207
Name:STRAFFIN-LEADER, BRIANAH MARIE
Entity type:Individual
Prefix:
First Name:BRIANAH
Middle Name:MARIE
Last Name:STRAFFIN-LEADER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:57 BOBCAT WAY
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03109-5143
Mailing Address - Country:US
Mailing Address - Phone:603-714-1802
Mailing Address - Fax:
Practice Address - Street 1:76 NORTHEASTERN BLVD STE 32B
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03062-3196
Practice Address - Country:US
Practice Address - Phone:603-714-1802
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-19
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling