Brittany Davenport

Individual provider Active NPI Behavior Technician · Troutman, NC

NPI 1164058806 · NPPES record last updated Mar 13, 2020

Key facts

NPI
1164058806
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
719 Ostwalt Amity Rd
Troutman, NC 28166-8768
Phone
(704) 380-7953
NPI assigned
Mar 13, 2020
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Yes

Addresses

Primary practice location

719 Ostwalt Amity Rd
Troutman, NC 28166-8768

Mailing address

719 Ostwalt Amity Rd
Troutman, NC 28166-8768
Phone (704) 380-7953

Other providers in Troutman, NC

All providers in Troutman, NC · Behavior Technician in North Carolina

Sources for this page

Verify at the official NPI Registry.