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General NPI Number Information
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NPI Number | 1215405337
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Entity Type | Individual
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Provider Name | BRITTANY PETTY
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Gender | Female
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Dates
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Enumeration Date | 11/06/2018
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Last Update Date | 04/07/2025
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Provider Practice Location Address
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Address Line | 320 LANIER AVE W STE 200
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City | FAYETTEVILLE
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State | GA
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Zip | 30214-7443
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Country | US
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Telephone | 404-400-5004
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Fax |
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Provider Business Mailing Address
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Address Line | 114 BLUE SPRINGS RD
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City | LOUISVILLE
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State | AL
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Zip | 36048-3307
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106E00000X
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Taxonomy Name | Assistant Behavior Analyst
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License Number | 0-20-11342
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License Number State |
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Taxonomy #2
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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