Provider Demographics
NPI:1750128336
Name:SMALLWOOD, BRITTNEY CANDICE
Entity type:Individual
Prefix:
First Name:BRITTNEY
Middle Name:CANDICE
Last Name:SMALLWOOD
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 1:426 LEON SULLIVAN WAY STE 134
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25301-1713
Mailing Address - Country:US
Mailing Address - Phone:304-533-7944
Mailing Address - Fax:
Practice Address - Street 1:426 LEON SULLIVAN WAY STE 134
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25301-1713
Practice Address - Country:US
Practice Address - Phone:304-533-7944
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-11
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator