Healthcare Provider Details

I. General information

NPI: 1700651163
Provider Name (Legal Business Name): BRITTNEY SYKES-MILLER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/16/2023
Last Update Date: 11/16/2023
Certification Date: 11/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1230 LIBERTY BANK LN STE 230
LOUISVILLE KY
40222-5756
US

IV. Provider business mailing address

8407 WINDWOOD CT
LOUISVILLE KY
40219-4244
US

V. Phone/Fax

Practice location:
  • Phone: 502-792-9269
  • Fax:
Mailing address:
  • Phone: 502-292-8043
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-23-305415
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: