Provider Demographics
NPI:1104655711
Name:KING, BRITANY
Entity type:Individual
Prefix:
First Name:BRITANY
Middle Name:
Last Name:KING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:BRITANY
Other - Middle Name:ANNE
Other - Last Name:SANCHEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:14491 M 65
Mailing Address - Street 2:
Mailing Address - City:POSEN
Mailing Address - State:MI
Mailing Address - Zip Code:49776-9455
Mailing Address - Country:US
Mailing Address - Phone:989-255-1746
Mailing Address - Fax:
Practice Address - Street 1:111 NEWMAN ST
Practice Address - Street 2:
Practice Address - City:EAST TAWAS
Practice Address - State:MI
Practice Address - Zip Code:48730-1272
Practice Address - Country:US
Practice Address - Phone:989-334-4837
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-31
Last Update Date:2024-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician