Provider Demographics
NPI:1639826126
Name:BOELTZ, BRITTANY ROSE
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:ROSE
Last Name:BOELTZ
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 1:2010 TALL GRASS LN UNIT 106
Mailing Address - Street 2:
Mailing Address - City:CANONSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15317-4724
Mailing Address - Country:US
Mailing Address - Phone:412-505-3927
Mailing Address - Fax:
Practice Address - Street 1:1720 WASHINGTON RD STE 208
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15241-1208
Practice Address - Country:US
Practice Address - Phone:412-854-4887
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-04
Last Update Date:2022-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker