Provider Demographics
NPI:1205376753
Name:BROUGHAL, BRITTANY (LMFT)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:
Last Name:BROUGHAL
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 WELLS AVE
Mailing Address - Street 2:
Mailing Address - City:CROTON ON HUDSON
Mailing Address - State:NY
Mailing Address - Zip Code:10520-2528
Mailing Address - Country:US
Mailing Address - Phone:646-468-8522
Mailing Address - Fax:
Practice Address - Street 1:2 WELLS AVE
Practice Address - Street 2:
Practice Address - City:CROTON ON HUDSON
Practice Address - State:NY
Practice Address - Zip Code:10520-2528
Practice Address - Country:US
Practice Address - Phone:646-468-8522
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-02
Last Update Date:2017-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001337106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist