Provider Demographics
NPI:1235968496
Name:BRITT, DESTINY RENEE
Entity type:Individual
Prefix:MRS
First Name:DESTINY
Middle Name:RENEE
Last Name:BRITT
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 1:1413C LOCUST ST # C
Mailing Address - Street 2:
Mailing Address - City:FORT DIX
Mailing Address - State:NJ
Mailing Address - Zip Code:08640-1820
Mailing Address - Country:US
Mailing Address - Phone:315-466-8094
Mailing Address - Fax:
Practice Address - Street 1:770 WOODLANE RD # C
Practice Address - Street 2:
Practice Address - City:WESTAMPTON
Practice Address - State:NJ
Practice Address - Zip Code:08060-3804
Practice Address - Country:US
Practice Address - Phone:315-466-8094
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-27
Last Update Date:2024-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health