Provider Demographics
NPI:1477209435
Name:HENRY, BRITTANY DESHUN
Entity Type:Individual
Prefix:MS
First Name:BRITTANY
Middle Name:DESHUN
Last Name:HENRY
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 1:6902 PARKRIDGE BLVD APT 311
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75063-9120
Mailing Address - Country:US
Mailing Address - Phone:985-215-2412
Mailing Address - Fax:
Practice Address - Street 1:6902 PARKRIDGE BLVD APT 311
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75063-9120
Practice Address - Country:US
Practice Address - Phone:985-215-2412
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-28
Last Update Date:2022-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician