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NPI Code Detail

MEDICARE: BRITTANY LEIGH SPAK MS

MEDICARE: BRITTANY LEIGH SPAK MS
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 CounselorVA

General Provider Information

NPI Number : 1952867160
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRITTANY LEIGH SPAK MS
Provider Business Mailing Address
First Line : 6627 W BROAD ST STE 400
Second Line :
City : RICHMOND
State : VA
Zip : 23230-1733
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6627 W BROAD ST STE 400
Second Line :
City : RICHMOND
State : VA
Zip : 23230-1733
Country : US
Telephone Number : 804-774-4820
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/12/2019
Last Update Date : 02/12/2019

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Directions to “ BRITTANY LEIGH SPAK MS” Practice Location

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