Provider Demographics
NPI:1023398880
Name:DEKOCH, BRITTANY (MS)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:
Last Name:DEKOCH
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1225 W HISTORIC MITCHELL ST
Mailing Address - Street 2:223
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53204-3383
Mailing Address - Country:US
Mailing Address - Phone:414-383-4455
Mailing Address - Fax:414-433-0171
Practice Address - Street 1:1225 W HISTORIC MITCHELL ST
Practice Address - Street 2:223
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53204-3383
Practice Address - Country:US
Practice Address - Phone:414-383-4455
Practice Address - Fax:414-433-0171
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-25
Last Update Date:2011-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health