Provider Demographics
NPI:1689181653
Name:MESSINA, BRITTANY (LBA, BCBA)
Entity Type:Individual
Prefix:MISS
First Name:BRITTANY
Middle Name:
Last Name:MESSINA
Suffix:
Gender:F
Credentials:LBA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8645 N PLEASANT VALLEY WAY
Mailing Address - Street 2:
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86004-3224
Mailing Address - Country:US
Mailing Address - Phone:716-450-0312
Mailing Address - Fax:480-898-7419
Practice Address - Street 1:4530 E MUIRWOOD DR STE 103
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85048-7693
Practice Address - Country:US
Practice Address - Phone:480-610-6981
Practice Address - Fax:480-898-7419
Is Sole Proprietor?:No
Enumeration Date:2017-12-29
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ153161Medicaid