Provider Demographics
NPI:1265814081
Name:HALL, BRITTANY (MA)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:
Last Name:HALL
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1355 S WINTER ST
Mailing Address - Street 2:APT. B19
Mailing Address - City:ADRIAN
Mailing Address - State:MI
Mailing Address - Zip Code:49221-4389
Mailing Address - Country:US
Mailing Address - Phone:517-902-8518
Mailing Address - Fax:
Practice Address - Street 1:9856 GAVIN LN
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49014-7400
Practice Address - Country:US
Practice Address - Phone:517-902-8518
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-29
Last Update Date:2020-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401015721101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health