Provider Demographics
NPI:1760718290
Name:BRITTAIN, CHRYSTAL (BSW-CM)
Entity Type:Individual
Prefix:
First Name:CHRYSTAL
Middle Name:
Last Name:BRITTAIN
Suffix:
Gender:F
Credentials:BSW-CM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:258 BRITTAIN LN
Mailing Address - Street 2:
Mailing Address - City:QUINTON
Mailing Address - State:OK
Mailing Address - Zip Code:74561-5072
Mailing Address - Country:US
Mailing Address - Phone:918-469-2742
Mailing Address - Fax:
Practice Address - Street 1:258 BRITTAIN LN
Practice Address - Street 2:
Practice Address - City:QUINTON
Practice Address - State:OK
Practice Address - Zip Code:74561-5072
Practice Address - Country:US
Practice Address - Phone:918-469-2742
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-18
Last Update Date:2011-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health