MEDICARE: BRITTANY D HOLDER M.A.,RBC,RTT,C.HYP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)
2	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1053023887
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRITTANY D HOLDER M.A.,RBC,RTT,C.HYP

Provider Business Mailing Address
First Line	:	10713 TEDDER LAKE DR
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46239-8993
Country	:	US
Telephone Number	:	833-777-6886
Fax Number	:

Provider Business Practice Location Address
First Line	:	10713 TEDDER LAKE DR
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46239-8993
Country	:	US
Telephone Number	:	833-777-6886
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/26/2022
Last Update Date	:	12/26/2022

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