Provider Demographics
NPI:1740573815
Name:DEWICK, BRITTANY ANN (BA)
Entity Type:Individual
Prefix:MS
First Name:BRITTANY
Middle Name:ANN
Last Name:DEWICK
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:257 CLARK ST
Mailing Address - Street 2:
Mailing Address - City:GREEN RIVER
Mailing Address - State:WY
Mailing Address - Zip Code:82935-4834
Mailing Address - Country:US
Mailing Address - Phone:307-352-6685
Mailing Address - Fax:
Practice Address - Street 1:2300 FOOTHILL BLVD
Practice Address - Street 2:
Practice Address - City:ROCK SPRINGS
Practice Address - State:WY
Practice Address - Zip Code:82901-5610
Practice Address - Country:US
Practice Address - Phone:307-352-6685
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-24
Last Update Date:2011-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator