Provider Demographics
NPI:1730798521
Name:BRITTAIN, BROOKE ALLISON (MS, RD, LD, CHES)
Entity type:Individual
Prefix:
First Name:BROOKE
Middle Name:ALLISON
Last Name:BRITTAIN
Suffix:
Gender:F
Credentials:MS, RD, LD, CHES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101B EDWARDS HALL
Mailing Address - Street 2:
Mailing Address - City:CLEMSON
Mailing Address - State:SC
Mailing Address - Zip Code:29634-0001
Mailing Address - Country:US
Mailing Address - Phone:864-656-1896
Mailing Address - Fax:
Practice Address - Street 1:200 BOOKER DR
Practice Address - Street 2:
Practice Address - City:WALHALLA
Practice Address - State:SC
Practice Address - Zip Code:29691-2278
Practice Address - Country:US
Practice Address - Phone:864-638-4279
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-28
Last Update Date:2021-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC935133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered