Provider Demographics
NPI:1275789620
Name:PAQUETTE, BRITTANY LACE (MS, LMHC)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:LACE
Last Name:PAQUETTE
Suffix:
Gender:F
Credentials:MS, LMHC
Other - Prefix:MISS
Other - First Name:BRITTANY
Other - Middle Name:LACE
Other - Last Name:LEGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4300 BAYOU BLVD. SUITE 35B UNIT 3
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32503-2304
Mailing Address - Country:US
Mailing Address - Phone:850-400-8371
Mailing Address - Fax:850-626-7171
Practice Address - Street 1:4300 BAYOU BLVD.
Practice Address - Street 2:SUITE 35B UNIT 3
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32503-3250
Practice Address - Country:US
Practice Address - Phone:850-400-8371
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-15
Last Update Date:2024-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH11770101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL014147100Medicaid