Provider Demographics
NPI:1972643443
Name:RANGER, BRITTANY JO (BA)
Entity type:Individual
Prefix:MRS
First Name:BRITTANY
Middle Name:JO
Last Name:RANGER
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36508 W. SANTA MARIA ST.
Mailing Address - Street 2:
Mailing Address - City:MARICOPA
Mailing Address - State:AZ
Mailing Address - Zip Code:85239
Mailing Address - Country:US
Mailing Address - Phone:480-678-1999
Mailing Address - Fax:
Practice Address - Street 1:10810 N TATUM BLVD
Practice Address - Street 2:BLDG102-185
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85028-6055
Practice Address - Country:US
Practice Address - Phone:602-452-6951
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLPS52202355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ141644Medicaid