Provider Demographics
NPI:1063759991
Name:ITNYRE, BRITTANY ELIZABETH (COTA)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:ELIZABETH
Last Name:ITNYRE
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:BRITTANY
Other - Middle Name:ELIZABETH
Other - Last Name:RONEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:COTA
Mailing Address - Street 1:3444 MIDVALE DR APT 8
Mailing Address - Street 2:
Mailing Address - City:JANESVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53546-3436
Mailing Address - Country:US
Mailing Address - Phone:608-386-7011
Mailing Address - Fax:
Practice Address - Street 1:1702 S RIVER RD
Practice Address - Street 2:
Practice Address - City:JANESVILLE
Practice Address - State:WI
Practice Address - Zip Code:53546-5648
Practice Address - Country:US
Practice Address - Phone:608-756-0344
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-11
Last Update Date:2020-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI287425224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant