Healthcare Provider Details

I. General information

NPI: 1164179990
Provider Name (Legal Business Name): BRITTANY CARPENTER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/02/2022
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

260 BEISER BLVD STE 102
DOVER DE
19904-5773
US

IV. Provider business mailing address

545 LEWES LANDING RD
MIDDLETOWN DE
19709-0028
US

V. Phone/Fax

Practice location:
  • Phone: 612-479-4749
  • Fax:
Mailing address:
  • Phone: 239-200-1504
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: