Healthcare Provider Details

I. General information

NPI: 1558724021
Provider Name (Legal Business Name): BRITTANY HOLMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2016
Last Update Date: 04/01/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

73 WHITE BRIDGE RD STE 103-232
NASHVILLE TN
37205-1444
US

IV. Provider business mailing address

73 WHITE BRIDGE RD STE 103-232
NASHVILLE TN
37205-1444
US

V. Phone/Fax

Practice location:
  • Phone: 615-916-0664
  • Fax: 615-953-2949
Mailing address:
  • Phone: 615-916-0664
  • Fax: 615-953-2949

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-16-21430
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: