Provider Demographics
NPI:1043556624
Name:MURRAY, BRITTNEY TATTERSALL (PSYD)
Entity type:Individual
Prefix:DR
First Name:BRITTNEY
Middle Name:TATTERSALL
Last Name:MURRAY
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:BRITTNEY
Other - Middle Name:TATTERSALL
Other - Last Name:BRISTOW-MURRAY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PSYD
Mailing Address - Street 1:3821 WOODBRIAR TRL STE 105
Mailing Address - Street 2:
Mailing Address - City:PORT ORANGE
Mailing Address - State:FL
Mailing Address - Zip Code:32129-9615
Mailing Address - Country:US
Mailing Address - Phone:312-978-7848
Mailing Address - Fax:
Practice Address - Street 1:3821 WOODBRIAR TRL STE 105
Practice Address - Street 2:
Practice Address - City:PORT ORANGE
Practice Address - State:FL
Practice Address - Zip Code:32129-9615
Practice Address - Country:US
Practice Address - Phone:312-978-7848
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-30
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY10811103G00000X
WI6150101YP2500X
IL180.009964101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional