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NPI Code Detail

MEDICARE: BRITTYN J FLICK BS

MEDICARE: BRITTYN J FLICK BS
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
1101Y00000XCounselor

General Provider Information

NPI Number : 1578162079
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRITTYN J FLICK BS
Provider Business Mailing Address
First Line : PO BOX 2394
Second Line :
City : LONGVIEW
State : WA
Zip : 98632-8455
Country : US
Telephone Number : 360-200-5419
Fax Number : 360-200-6736
Provider Business Practice Location Address
First Line : 1616 S GOLD ST STE 4
Second Line :
City : CENTRALIA
State : WA
Zip : 98531-8930
Country : US
Telephone Number : 360-807-4929
Fax Number : 360-807-4160
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/26/2020
Last Update Date : 10/26/2020

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