MEDICARE: MS. KENDREE BRINAE BITTER MAS-LAMFT

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	106H00000X	Marriage & Family Therapist	10758	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1114552395
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KENDREE BRINAE BITTER MAS-LAMFT

Provider Business Mailing Address
First Line	:	1151 E VIA NICOLA
Second Line	:
City	:	SAN TAN VALLEY
State	:	AZ
Zip	:	85140-8917
Country	:	US
Telephone Number	:	480-240-0342
Fax Number	:

Provider Business Practice Location Address
First Line	:	21455 S ELLSWORTH RD UNIT 44
Second Line	:
City	:	QUEEN CREEK
State	:	AZ
Zip	:	85142-9849
Country	:	US
Telephone Number	:	480-240-0342
Fax Number	:

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

Provider Enumeration Date	:	03/07/2020
Last Update Date	:	09/20/2021

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