Provider Demographics
NPI:1386024255
Name:WIERZBA, BRITTANY C (PHD)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:C
Last Name:WIERZBA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:BRITTANY
Other - Middle Name:C
Other - Last Name:PUTNAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:4920 MYAKKA VALLEY TRL
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34241-9749
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4920 MYAKKA VALLEY TRL
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34241-9749
Practice Address - Country:US
Practice Address - Phone:941-961-2367
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-04
Last Update Date:2017-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst