Provider Demographics
NPI:1851745772
Name:DAVIS, BRITTANEE' R
Entity type:Individual
Prefix:
First Name:BRITTANEE'
Middle Name:R
Last Name:DAVIS
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 1:261 EASY ST
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:LA
Mailing Address - Zip Code:70538-3338
Mailing Address - Country:US
Mailing Address - Phone:337-578-2293
Mailing Address - Fax:337-703-0524
Practice Address - Street 1:6100 WESTERN PL STE 908
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76107-4600
Practice Address - Country:US
Practice Address - Phone:817-751-7802
Practice Address - Fax:847-859-5885
Is Sole Proprietor?:No
Enumeration Date:2016-04-17
Last Update Date:2024-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA6709101YM0800X
LA12167104100000X
TX81738101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No104100000XBehavioral Health & Social Service ProvidersSocial Worker