Provider Demographics
NPI:1093025769
Name:STENDER, BRITTANI LEIGH
Entity Type:Individual
Prefix:MRS
First Name:BRITTANI
Middle Name:LEIGH
Last Name:STENDER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:BRITTANI
Other - Middle Name:
Other - Last Name:STEVENSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2708 NE 14TH STREET, SUITE 5
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33062
Mailing Address - Country:US
Mailing Address - Phone:954-603-7885
Mailing Address - Fax:954-342-0273
Practice Address - Street 1:2708 NE 14TH STREET, SUITE 5
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33062
Practice Address - Country:US
Practice Address - Phone:954-603-7885
Practice Address - Fax:954-342-0273
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-15
Last Update Date:2010-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC222Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCPENDINGMedicaid