Provider Demographics
NPI:1528803905
Name:WYATT, BRITNEY SHYAN
Entity type:Individual
Prefix:
First Name:BRITNEY
Middle Name:SHYAN
Last Name:WYATT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2934 WHALEY RD
Mailing Address - Street 2:
Mailing Address - City:NEW MARKET
Mailing Address - State:TN
Mailing Address - Zip Code:37820-3039
Mailing Address - Country:US
Mailing Address - Phone:865-585-7052
Mailing Address - Fax:
Practice Address - Street 1:2934 WHALEY RD
Practice Address - Street 2:
Practice Address - City:NEW MARKET
Practice Address - State:TN
Practice Address - Zip Code:37820-3039
Practice Address - Country:US
Practice Address - Phone:865-585-7052
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-27
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician