Provider Demographics
NPI:1578238820
Name:MCCONNELL, BRITTANY (RBT)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:
Last Name:MCCONNELL
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:BRITTANY
Other - Middle Name:
Other - Last Name:MCCONNELL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RBT
Mailing Address - Street 1:21102 ARCHSTONE WAY APT 304
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20876-6986
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1651 CROFTON BLVD STE 6
Practice Address - Street 2:
Practice Address - City:CROFTON
Practice Address - State:MD
Practice Address - Zip Code:21114-1314
Practice Address - Country:US
Practice Address - Phone:443-624-7651
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-10
Last Update Date:2021-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician