Healthcare Provider Details

I. General information

NPI: 1649763285
Provider Name (Legal Business Name): BRITNEY COLLETTE SPELL LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2018
Last Update Date: 08/16/2022
Certification Date: 08/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2502 E. HUNTINGTON DR.
DUARTE CA
91010
US

IV. Provider business mailing address

2502 E. HUNTINGTON DR.
DUARTE CA
91010
US

V. Phone/Fax

Practice location:
  • Phone: 626-263-9133
  • Fax: 626-288-8903
Mailing address:
  • Phone: 626-263-9133
  • Fax: 626-288-8903

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMFT116332
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberAMFT104492
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: