Provider Demographics
NPI:1932093242
Name:RICHARDSON, BRITTNY (LAC)
Entity type:Individual
Prefix:
First Name:BRITTNY
Middle Name:
Last Name:RICHARDSON
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:445 E ILLINOIS ST UNIT 3604
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-5368
Mailing Address - Country:US
Mailing Address - Phone:305-713-2295
Mailing Address - Fax:
Practice Address - Street 1:233 E REDWOOD ST STE 801
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21202-3332
Practice Address - Country:US
Practice Address - Phone:305-713-2295
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-03
Last Update Date:2025-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU03226171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist