Provider Demographics
NPI:1093497513
Name:EMBRY, BRITTANY (ATR-P)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:
Last Name:EMBRY
Suffix:
Gender:F
Credentials:ATR-P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3739 TRADEWINDS TER
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37040-6328
Mailing Address - Country:US
Mailing Address - Phone:812-604-2885
Mailing Address - Fax:
Practice Address - Street 1:1002 S VIRGINIA ST STE 401
Practice Address - Street 2:
Practice Address - City:HOPKINSVILLE
Practice Address - State:KY
Practice Address - Zip Code:42240-3507
Practice Address - Country:US
Practice Address - Phone:270-881-2142
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-03
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
23-230221700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor