Ketchup Hall, Brittany
Ketchup Hall, Brittany is an individual health care provider with primary practice located at 1025 Veterans Memorial Hwy Se Ste 660 , Mableton GA 30126-7711. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Professional, Other Service Providers / Contractor, Student, Health Care / Student in an Organized Health Care Education/Training Program. Behavioral Health & Social Service Providers / Professional is her primary health care specialty. Ketchup Hall, Brittany can be contacted via phone (678) 696-1824.Contact Information
Primary practice address
1025 Veterans Memorial Hwy Se Ste 660
Mableton GA 30126-7711
Phone: (678) 696-1824
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | APC006917 | Georgia |
| Other Service Providers / Contractor | 171W00000X | ||
| Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | ||
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | LPC012859 | Georgia |
Profile Details
| NPI number | 1881112217 |
|---|---|
| LBN Legal business name | Ketchup Hall, Brittany |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 6th, 2017 |
| Last updated | Aug 24th, 2022 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1881112217 | NPPES |
| California | MEDICAID | 7068 | |
| California | MEDICAID | 6758 | |
| California | MEDICAID | 7420 |
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