Provider Demographics
NPI:1013790864
Name:PETZ, BRITTANY
Entity type:Individual
Prefix:MRS
First Name:BRITTANY
Middle Name:
Last Name:PETZ
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:BRITTANY
Other - Middle Name:
Other - Last Name:PHILLIPS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:514 W MAPLE ST STE 1206
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30040-2536
Mailing Address - Country:US
Mailing Address - Phone:770-844-7826
Mailing Address - Fax:
Practice Address - Street 1:514 W MAPLE ST STE 1206
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30040-2536
Practice Address - Country:US
Practice Address - Phone:770-844-7826
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-16
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)