MEDICARE: BRITTNEY CARR

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	106S00000X	Behavior Technician	RBT-20-149915	MO

General Provider Information

NPI Number	:	1679231328
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRITTNEY CARR

Provider Business Mailing Address
First Line	:	7373 PERSHING AVE
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63130-4280
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2055 CRAIGSHIRE RD
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63146-4036
Country	:	US
Telephone Number	:	314-275-0506
Fax Number	:

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

Provider Enumeration Date	:	11/30/2021
Last Update Date	:	11/30/2021

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Directions to “ BRITTNEY CARR ” Practice Location

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