Healthcare Provider Details

I. General information

NPI: 1043685803
Provider Name (Legal Business Name): BRITTNEY HARTMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/04/2015
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 N OAK ST
COLUMBIA CITY IN
46725-1218
US

IV. Provider business mailing address

5601 COVENTRY LN
FORT WAYNE IN
46804-7145
US

V. Phone/Fax

Practice location:
  • Phone: 260-459-6040
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: