Provider Demographics
NPI:1144623018
Name:LOUREA-WADDELL, BRITTANY JILL (PHD)
Entity Type:Individual
Prefix:DR
First Name:BRITTANY
Middle Name:JILL
Last Name:LOUREA-WADDELL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 KULP RD E
Mailing Address - Street 2:
Mailing Address - City:CHALFONT
Mailing Address - State:PA
Mailing Address - Zip Code:18914-3731
Mailing Address - Country:US
Mailing Address - Phone:215-630-4504
Mailing Address - Fax:
Practice Address - Street 1:35 KULP RD E
Practice Address - Street 2:
Practice Address - City:CHALFONT
Practice Address - State:PA
Practice Address - Zip Code:18914-3731
Practice Address - Country:US
Practice Address - Phone:215-630-4504
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-06
Last Update Date:2014-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS017697103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist