Healthcare Provider Details

I. General information

NPI: 1689001919
Provider Name (Legal Business Name): BRITTANY PRINTZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2013
Last Update Date: 11/20/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8200 WOODGLEN LN #201
DOWNERS GROVE IL
60516-4551
US

IV. Provider business mailing address

9179 BIRCH RD
ROSHOLT WI
54473-8819
US

V. Phone/Fax

Practice location:
  • Phone: 602-471-6802
  • Fax: 630-395-9198
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: