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General NPI Number Information
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NPI Number | 1972161065
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Entity Type | Individual
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Provider Name | BRITTNI AMBER FUTRELL
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Gender | Female
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Dates
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Enumeration Date | 06/03/2019
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Last Update Date | 07/08/2024
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Provider Practice Location Address
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Address Line | 634 N MAIN ST STE 4
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City | O FALLON
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State | IL
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Zip | 62269-3746
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Country | US
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Telephone | 618-726-5870
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Fax |
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Provider Business Mailing Address
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Address Line | 671 SPRINGFIELD DR
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City | WENTZVILLE
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State | MO
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Zip | 63385-9082
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Country | US
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Telephone | 636-409-2650
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 2023011865
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License Number State | MO
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