MEDICARE: BRITTANY PENSON-PROTHRO

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	103TC0700X	Clinical Psychologist	PSY004539	GA

General Provider Information

NPI Number	:	1306771597
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRITTANY PENSON-PROTHRO

Provider Business Mailing Address
First Line	:	1935 LUCY COMPTON LN NW
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30318-4491
Country	:	US
Telephone Number	:	770-910-0809
Fax Number	:

Provider Business Practice Location Address
First Line	:	1935 LUCY COMPTON LN NW
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30318-4491
Country	:	US
Telephone Number	:	770-910-0809
Fax Number	:

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

Provider Enumeration Date	:	06/17/2026
Last Update Date	:	06/17/2026

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Directions to “ BRITTANY PENSON-PROTHRO ” Practice Location

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