Provider Demographics
NPI:1124521257
Name:WILLIAMSON, BRITTANY SHANE
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:SHANE
Last Name:WILLIAMSON
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 1:2813 SANDERSVILLE RD UNIT 114
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40511-8531
Mailing Address - Country:US
Mailing Address - Phone:859-533-6141
Mailing Address - Fax:
Practice Address - Street 1:1906 GOLDSMITH LN
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40218-2066
Practice Address - Country:US
Practice Address - Phone:888-636-8477
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-15
Last Update Date:2018-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist