Healthcare Provider Details

I. General information

NPI: 1235872516
Provider Name (Legal Business Name): BRITTANY STALLINGS MFT-ASSOCIATE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/15/2022
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3374 N 1200 E
BUHL ID
83316-6250
US

IV. Provider business mailing address

3374 N 1200 E
BUHL ID
83316-6250
US

V. Phone/Fax

Practice location:
  • Phone: 254-978-7103
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number204531
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number4771591
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: