Provider Demographics
NPI:1336638923
Name:EDWARDS, BRITTANY ARIANA
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:ARIANA
Last Name:EDWARDS
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 1:457 HUNTINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:HYDE PARK
Mailing Address - State:MA
Mailing Address - Zip Code:02136-3103
Mailing Address - Country:US
Mailing Address - Phone:857-334-8762
Mailing Address - Fax:
Practice Address - Street 1:457 HUNTINGTON AVE
Practice Address - Street 2:
Practice Address - City:HYDE PARK
Practice Address - State:MA
Practice Address - Zip Code:02136-3103
Practice Address - Country:US
Practice Address - Phone:857-334-8762
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-09
Last Update Date:2018-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker