Provider Demographics
NPI:1699824870
Name:THATCHER, BRITTANY J (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:J
Last Name:THATCHER
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1677 GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:BUTTE
Mailing Address - State:MT
Mailing Address - Zip Code:59701-4817
Mailing Address - Country:US
Mailing Address - Phone:406-490-9883
Mailing Address - Fax:
Practice Address - Street 1:1677 GRAND AVE
Practice Address - Street 2:
Practice Address - City:BUTTE
Practice Address - State:MT
Practice Address - Zip Code:59701-4817
Practice Address - Country:US
Practice Address - Phone:406-490-9883
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTSP 1061235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0534616Medicaid