Provider Demographics
NPI:1528363355
Name:SUDDERTH, BRITTANY G (MS, LMFT)
Entity Type:Individual
Prefix:MRS
First Name:BRITTANY
Middle Name:G
Last Name:SUDDERTH
Suffix:
Gender:F
Credentials:MS, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4059 LOMITA LN
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75220-3727
Mailing Address - Country:US
Mailing Address - Phone:214-215-5331
Mailing Address - Fax:
Practice Address - Street 1:4059 LOMITA LN
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75220-3727
Practice Address - Country:US
Practice Address - Phone:214-215-5331
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-26
Last Update Date:2011-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX201135106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist