Basic Information
| Provider Information | |||||||||
| NPI: | 1639668700 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | STALEY | ||||||||
| FirstName: | BRITTANY | ||||||||
| MiddleName: | COLLINS | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | PHD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1937 THOMSON DR | ||||||||
| Address2: | |||||||||
| City: | LYNCHBURG | ||||||||
| State: | VA | ||||||||
| PostalCode: | 245011008 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4342006484 | ||||||||
| FaxNumber: | 4342006490 | ||||||||
| Practice Location | |||||||||
| Address1: | 3300 RIVERMONT AVE | ||||||||
| Address2: | |||||||||
| City: | LYNCHBURG | ||||||||
| State: | VA | ||||||||
| PostalCode: | 245032030 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4342005999 | ||||||||
| FaxNumber: | 4342001673 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/04/2018 | ||||||||
| LastUpdateDate: | 06/18/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103T00000X | 0810005639 | VA | Y | Behavioral Health & Social Service Providers | Psychologist |
No ID Information.