MEDICARE: BRITTEN MOYERS M.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1073910410
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRITTEN MOYERS M.S.

Provider Business Mailing Address
First Line	:	9816 CARR RD
Second Line	:
City	:	RIVERVIEW
State	:	FL
Zip	:	33569-5608
Country	:	US
Telephone Number	:	216-695-0327
Fax Number	:

Provider Business Practice Location Address
First Line	:	3455 58TH AVE N
Second Line	:
City	:	ST PETERSBURG
State	:	FL
Zip	:	33714-1226
Country	:	US
Telephone Number	:	727-231-5470
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/01/2014
Last Update Date	:	12/01/2014

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