Provider Demographics
NPI:1689913014
Name:FURR PATTON, BRYCELYN N
Entity type:Individual
Prefix:
First Name:BRYCELYN
Middle Name:N
Last Name:FURR PATTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:BRYCELYN
Other - Middle Name:N
Other - Last Name:FURR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2039 E LAKE MEAD BLVD
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89030-7135
Mailing Address - Country:US
Mailing Address - Phone:702-724-9300
Mailing Address - Fax:702-724-9305
Practice Address - Street 1:2039 E LAKE MEAD BLVD
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89030-7135
Practice Address - Country:US
Practice Address - Phone:702-724-9300
Practice Address - Fax:702-724-9305
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-05
Last Update Date:2013-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst