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General NPI Number Information
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NPI Number | 1679135495
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Entity Type | Individual
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Provider Name | BRITTANY NICHOLE WOLFGANG MASTERS
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Gender | Female
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Dates
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Enumeration Date | 07/01/2019
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Last Update Date | 03/24/2025
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Provider Practice Location Address
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Address Line | 400 ROUNDS DR
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City | FENTON
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State | MI
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Zip | 48430-1724
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Country | US
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Telephone | 810-629-0530
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Fax |
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Provider Business Mailing Address
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Address Line | 184 N MAIN ST STE A
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City | FRANKENMUTH
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State | MI
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Zip | 48734-1255
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Country | US
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Telephone | 989-262-8500
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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 |
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 5201013261
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License Number State | MN
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Taxonomy #3
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 5201013261
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License Number State | MI
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