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General NPI Number Information
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NPI Number | 1629558002
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Entity Type | Individual
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Provider Name | BRITTANY DANIELLE RUSH
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Gender | Female
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Dates
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Enumeration Date | 08/15/2018
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Last Update Date | 08/15/2018
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Provider Practice Location Address
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Address Line | 1445 E 10TH ST
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City | COOKEVILLE
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State | TN
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Zip | 38501-2017
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Country | US
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Telephone | 800-423-2559
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Fax |
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Provider Business Mailing Address
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Address Line | 736 OLD CELINA RD
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City | ALLONS
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State | TN
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Zip | 38541-6908
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Country | US
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Telephone | 931-823-6408
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | RBT-18-62876
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License Number State | TN
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