Provider Demographics
NPI:1760059117
Name:MUNCH, BRITTANY ANN (BCBA)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:ANN
Last Name:MUNCH
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25920 DERBY DR
Mailing Address - Street 2:
Mailing Address - City:MONEE
Mailing Address - State:IL
Mailing Address - Zip Code:60449-8086
Mailing Address - Country:US
Mailing Address - Phone:708-466-0046
Mailing Address - Fax:
Practice Address - Street 1:11301 S HARLEM AVE
Practice Address - Street 2:
Practice Address - City:WORTH
Practice Address - State:IL
Practice Address - Zip Code:60482-2001
Practice Address - Country:US
Practice Address - Phone:866-273-8060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-04
Last Update Date:2021-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-21-48898103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst