Provider Demographics
NPI:1811461833
Name:CORNELL, BRITTANY RENEE
Entity type:Individual
Prefix:MRS
First Name:BRITTANY
Middle Name:RENEE
Last Name:CORNELL
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 1:109 CURRITUCK COMMERICAL DR
Mailing Address - Street 2:
Mailing Address - City:MOYOCK
Mailing Address - State:NC
Mailing Address - Zip Code:27958-9066
Mailing Address - Country:US
Mailing Address - Phone:252-435-1665
Mailing Address - Fax:
Practice Address - Street 1:109 CURRITUCK COMMERICAL DR
Practice Address - Street 2:
Practice Address - City:MOYOCK
Practice Address - State:NC
Practice Address - Zip Code:27958-9066
Practice Address - Country:US
Practice Address - Phone:757-502-3247
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-12
Last Update Date:2023-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician