Provider Demographics
NPI:1942680475
Name:DEBOER, BRITTANY
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:
Last Name:DEBOER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4501 N 22ND ST
Mailing Address - Street 2:150
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-0600
Mailing Address - Country:US
Mailing Address - Phone:602-237-6653
Mailing Address - Fax:602-957-3600
Practice Address - Street 1:4501 N 22ND ST
Practice Address - Street 2:150
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-0600
Practice Address - Country:US
Practice Address - Phone:602-237-6653
Practice Address - Fax:602-957-3600
Is Sole Proprietor?:No
Enumeration Date:2015-05-29
Last Update Date:2015-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst