Provider Demographics
NPI:1154848331
Name:ALDEN, BRITTANY
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:
Last Name:ALDEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 COMMERCIAL CT STE F
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34292-1650
Mailing Address - Country:US
Mailing Address - Phone:941-485-0121
Mailing Address - Fax:
Practice Address - Street 1:411 COMMERCIAL CT STE F
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34292-1650
Practice Address - Country:US
Practice Address - Phone:941-485-0121
Practice Address - Fax:941-485-0121
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-28
Last Update Date:2020-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-20-41909103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty