Provider Demographics
NPI:1174988273
Name:FAILS, BRITTANY
Entity type:Individual
Prefix:MISS
First Name:BRITTANY
Middle Name:
Last Name:FAILS
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 1:10201 GRAND CENTRAL AVE
Mailing Address - Street 2:APT. 507
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-3994
Mailing Address - Country:US
Mailing Address - Phone:540-905-3851
Mailing Address - Fax:
Practice Address - Street 1:4155 GLEN PARK RD
Practice Address - Street 2:
Practice Address - City:NOTTINGHAM
Practice Address - State:MD
Practice Address - Zip Code:21236-1019
Practice Address - Country:US
Practice Address - Phone:410-529-0348
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-16
Last Update Date:2015-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD07945235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist