Provider Demographics
NPI:1609265206
Name:BURRELL, BRITTANY BREANN
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:BREANN
Last Name:BURRELL
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 1:110 S BRUSH CREEK RD
Mailing Address - Street 2:
Mailing Address - City:STILLWATER
Mailing Address - State:OK
Mailing Address - Zip Code:74075-8308
Mailing Address - Country:US
Mailing Address - Phone:409-651-5418
Mailing Address - Fax:405-743-1440
Practice Address - Street 1:110 S BRUSH CREEK RD
Practice Address - Street 2:
Practice Address - City:STILLWATER
Practice Address - State:OK
Practice Address - Zip Code:74075-8308
Practice Address - Country:US
Practice Address - Phone:409-651-5418
Practice Address - Fax:405-743-1440
Is Sole Proprietor?:No
Enumeration Date:2015-01-20
Last Update Date:2015-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health