Provider Demographics
NPI:1558930339
Name:HACKETT, BRITTNEY
Entity Type:Individual
Prefix:
First Name:BRITTNEY
Middle Name:
Last Name:HACKETT
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 1:789 PATTERSON DR
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:MI
Mailing Address - Zip Code:48161-1843
Mailing Address - Country:US
Mailing Address - Phone:734-652-9867
Mailing Address - Fax:
Practice Address - Street 1:15384 S DIXIE HWY
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:MI
Practice Address - Zip Code:48161-3773
Practice Address - Country:US
Practice Address - Phone:734-682-3864
Practice Address - Fax:184-427-2130
Is Sole Proprietor?:No
Enumeration Date:2021-06-24
Last Update Date:2021-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician