Provider Demographics
NPI:1851173710
Name:BRITO, MARIANELA O
Entity Type:Individual
Prefix:MS
First Name:MARIANELA
Middle Name:O
Last Name:BRITO
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 1:5959 GATEWAY BLVD W STE 655
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79925-3326
Mailing Address - Country:US
Mailing Address - Phone:915-455-7150
Mailing Address - Fax:832-218-9001
Practice Address - Street 1:5959 GATEWAY BLVD W
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79925-3331
Practice Address - Country:US
Practice Address - Phone:915-455-7150
Practice Address - Fax:832-218-9001
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-16
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty