Provider Demographics
NPI:1275127607
Name:BUCZKOWSKI, BRITNEY RENE
Entity Type:Individual
Prefix:
First Name:BRITNEY
Middle Name:RENE
Last Name:BUCZKOWSKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3307 N 7TH ST
Mailing Address - Street 2:
Mailing Address - City:ONAWAY
Mailing Address - State:MI
Mailing Address - Zip Code:49765-8614
Mailing Address - Country:US
Mailing Address - Phone:989-370-1669
Mailing Address - Fax:
Practice Address - Street 1:3307 N 7TH ST
Practice Address - Street 2:
Practice Address - City:ONAWAY
Practice Address - State:MI
Practice Address - Zip Code:49765-8614
Practice Address - Country:US
Practice Address - Phone:989-370-1669
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-25
Last Update Date:2021-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician