Provider Demographics
NPI:1861144578
Name:NDABIAN, BRITTANY LEIGH
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:LEIGH
Last Name:NDABIAN
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 1:1335 44TH AVE N STE 103
Mailing Address - Street 2:
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29577-5978
Mailing Address - Country:US
Mailing Address - Phone:843-604-5320
Mailing Address - Fax:
Practice Address - Street 1:1335 44TH AVE N STE 103
Practice Address - Street 2:
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29577-5978
Practice Address - Country:US
Practice Address - Phone:843-604-5320
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-24
Last Update Date:2022-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator