Healthcare Provider Details
I. General information
NPI: 1336720317
Provider Name (Legal Business Name): BRITNEY JEAN HANSEN MA
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/20/2021
Last Update Date: 11/01/2024
Certification Date: 11/01/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1617 WEST 150 SOUTH, CLEARFIELD, UT 84015
WEST POINT UT
84015
US
IV. Provider business mailing address
1617 WEST 150 SOUTH, CLEARFIELD, UT 84015
WEST POINT UT
84015
US
V. Phone/Fax
- Phone: 435-225-5669
- Fax:
- Phone: 435-225-5669
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | 1-24-77066 |
| License Number State | UT |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 106S00000X |
| Taxonomy | Behavior Technician |
| License Number | |
| License Number State | NULL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: