Healthcare Provider Details

I. General information

NPI: 1477401172
Provider Name (Legal Business Name): BRITTNI BROWN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/18/2026
Last Update Date: 03/18/2026
Certification Date: 03/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 S 2ND ST
CLINTON MO
64735-2117
US

IV. Provider business mailing address

32987 HIGHWAY MM LOT 101
WARSAW MO
65355-7270
US

V. Phone/Fax

Practice location:
  • Phone: 660-219-9176
  • Fax:
Mailing address:
  • Phone: 660-723-2857
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberBACB1370059
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: