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NPI Code Detail

MEDICARE: BRITTANY SUE CHILDRESS

MEDICARE: BRITTANY SUE CHILDRESS
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
1101YM0800XMental Health Counselor11772NE
21041C0700XClinical Social Worker7347NE

General Provider Information

NPI Number : 1093371171
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRITTANY SUE CHILDRESS
Provider Business Mailing Address
First Line : 829 W PARK ST
Second Line :
City : ALBION
State : NE
Zip : 68620-1532
Country : US
Telephone Number : 402-741-9027
Fax Number :
Provider Business Practice Location Address
First Line : 1460 35TH AVE
Second Line :
City : COLUMBUS
State : NE
Zip : 68601-4731
Country : US
Telephone Number : 402-562-6767
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/14/2019
Last Update Date : 05/14/2019

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Directions to “ BRITTANY SUE CHILDRESS ” Practice Location

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