Provider Demographics
NPI:1700364411
Name:PETERSON, BRITTANY ROSE (RBT)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:ROSE
Last Name:PETERSON
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2632 YELLOWSTONE AVE
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-3855
Mailing Address - Country:US
Mailing Address - Phone:406-860-6741
Mailing Address - Fax:
Practice Address - Street 1:1610 POLY DR
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-1724
Practice Address - Country:US
Practice Address - Phone:406-259-1680
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-03
Last Update Date:2018-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician