MEDICARE: BRITTANY PHELPS

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	106H00000X	Marriage & Family Therapist	2795	MN

General Provider Information

NPI Number	:	1164827580
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRITTANY PHELPS

Provider Business Mailing Address
First Line	:	134 16TH AVE S
Second Line	:
City	:	SAINT CLOUD
State	:	MN
Zip	:	56301-4120
Country	:	US
Telephone Number	:	320-237-7874
Fax Number	:

Provider Business Practice Location Address
First Line	:	1511 E MINNESOTA ST
Second Line	:
City	:	SAINT JOSEPH
State	:	MN
Zip	:	56374-8618
Country	:	US
Telephone Number	:	320-237-7874
Fax Number	:

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

Provider Enumeration Date	:	10/28/2014
Last Update Date	:	06/05/2024

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