Provider Demographics
NPI:1851020689
Name:REYNOLDS, BRITTANY SANDYELL (CIT)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:SANDYELL
Last Name:REYNOLDS
Suffix:
Gender:F
Credentials:CIT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 MORRIS AVE
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71202-2067
Mailing Address - Country:US
Mailing Address - Phone:318-600-3962
Mailing Address - Fax:318-816-5514
Practice Address - Street 1:201 MORRIS AVE # 71202
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71202-2067
Practice Address - Country:US
Practice Address - Phone:318-600-3962
Practice Address - Fax:318-816-5514
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-07
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LACIT-5455101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty