Provider Demographics
NPI:1043732068
Name:SCHWANKE, BRITTANY MICHELLE (MED, BCBA, LBA)
Entity Type:Individual
Prefix:MRS
First Name:BRITTANY
Middle Name:MICHELLE
Last Name:SCHWANKE
Suffix:
Gender:F
Credentials:MED, BCBA, LBA
Other - Prefix:MS
Other - First Name:BRITTANY
Other - Middle Name:MICHELLE
Other - Last Name:BLAKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9100 BROMBACH ST
Mailing Address - Street 2:
Mailing Address - City:HAMTRAMCK
Mailing Address - State:MI
Mailing Address - Zip Code:48212-3473
Mailing Address - Country:US
Mailing Address - Phone:313-972-9100
Mailing Address - Fax:313-972-9040
Practice Address - Street 1:9100 BROMBACH ST
Practice Address - Street 2:
Practice Address - City:HAMTRAMCK
Practice Address - State:MI
Practice Address - Zip Code:48212-3473
Practice Address - Country:US
Practice Address - Phone:313-972-3050
Practice Address - Fax:313-447-1104
Is Sole Proprietor?:No
Enumeration Date:2017-07-11
Last Update Date:2023-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI1-17-26274103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst