Healthcare Provider Details

I. General information

NPI: 1093497513
Provider Name (Legal Business Name): BRITTANY EMBRY ATR-P
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2023
Last Update Date: 08/03/2023
Certification Date: 08/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1002 S VIRGINIA ST STE 401
HOPKINSVILLE KY
42240-3507
US

IV. Provider business mailing address

3739 TRADEWINDS TER
CLARKSVILLE TN
37040-6328
US

V. Phone/Fax

Practice location:
  • Phone: 270-881-2142
  • Fax:
Mailing address:
  • Phone: 812-604-2885
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code221700000X
TaxonomyArt Therapist
License Number23-230
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: