Provider Demographics
NPI:1083171714
Name:WILLIAMS, BRITTNI JENE' (MED, BCBA)
Entity Type:Individual
Prefix:
First Name:BRITTNI
Middle Name:JENE'
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MED, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2260 NORTHLAKE PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:TUCKER
Mailing Address - State:GA
Mailing Address - Zip Code:30084-4006
Mailing Address - Country:US
Mailing Address - Phone:404-594-1268
Mailing Address - Fax:404-883-3991
Practice Address - Street 1:2260 NORTHLAKE PKWY STE 100
Practice Address - Street 2:
Practice Address - City:TUCKER
Practice Address - State:GA
Practice Address - Zip Code:30084-4006
Practice Address - Country:US
Practice Address - Phone:404-594-1268
Practice Address - Fax:404-883-3991
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-28
Last Update Date:2020-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1-18-29173103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst