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General NPI Number Information
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NPI Number | 1114552395
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Entity Type | Individual
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Provider Name | KENDREE BRINAE BITTER MAS-LAMFT
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Gender | Female
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Dates
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Enumeration Date | 03/07/2020
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Last Update Date | 09/20/2021
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Provider Practice Location Address
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Address Line | 21455 S ELLSWORTH RD UNIT 44
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City | QUEEN CREEK
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State | AZ
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Zip | 85142-9849
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Country | US
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Telephone | 480-240-0342
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Fax |
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Provider Business Mailing Address
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Address Line | 1151 E VIA NICOLA
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City | SAN TAN VALLEY
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State | AZ
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Zip | 85140-8917
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Country | US
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Telephone | 480-240-0342
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 10758
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License Number State | AZ
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