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NPI Code Detail

MEDICARE: BRIANNA PUTNAM BSW

MEDICARE: BRIANNA PUTNAM BSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106E00000XAssistant Behavior Analyst
2106S00000XBehavior Technician
3171M00000XCase Manager/Care Coordinator
4103K00000XBehavior Analyst

General Provider Information

NPI Number : 1912392952
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRIANNA PUTNAM BSW
Provider Business Mailing Address
First Line : PO BOX 663
Second Line :
City : LAKELAND
State : MI
Zip : 48143-0663
Country : US
Telephone Number : 810-599-2129
Fax Number :
Provider Business Practice Location Address
First Line : 1625 CONCENTRIC BLVD
Second Line :
City : SAGINAW
State : MI
Zip : 48604-9542
Country : US
Telephone Number : 989-262-0633
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/06/2015
Last Update Date : 07/22/2025

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