Provider Demographics
NPI:1508289737
Name:LOTS, BRITTANI
Entity Type:Individual
Prefix:
First Name:BRITTANI
Middle Name:
Last Name:LOTS
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 1:5150 S WASHINGTON BLVD STE 1
Mailing Address - Street 2:
Mailing Address - City:SOUTH OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84405-4503
Mailing Address - Country:US
Mailing Address - Phone:801-337-0067
Mailing Address - Fax:
Practice Address - Street 1:5150 S WASHINGTON BLVD STE 1
Practice Address - Street 2:
Practice Address - City:SOUTH OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84405-4503
Practice Address - Country:US
Practice Address - Phone:801-337-0067
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-23
Last Update Date:2014-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor