Healthcare Provider Details

I. General information

NPI: 1598385619
Provider Name (Legal Business Name): BRITTANY KING
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/18/2020
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

882 TIOGA TRL REAR
WILLOUGHBY OH
44094-7231
US

IV. Provider business mailing address

882 TIOGA TRL REAR
WILLOUGHBY OH
44094-7231
US

V. Phone/Fax

Practice location:
  • Phone: 440-296-2299
  • Fax:
Mailing address:
  • Phone: 440-296-2299
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License NumberPRS.007608
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: