Provider Demographics
NPI:1891303178
Name:MACH, BRITTANY MICHELE (BCBA)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:MICHELE
Last Name:MACH
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 1:4865 CRESTSIDE DR
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89436-3665
Mailing Address - Country:US
Mailing Address - Phone:907-841-7494
Mailing Address - Fax:
Practice Address - Street 1:5375 RENO CORPORATE DR
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89511-2381
Practice Address - Country:US
Practice Address - Phone:775-376-9426
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-22
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X
AK106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst