Provider Demographics
NPI:1205466794
Name:WEDGE, BRITTNEY MARIE (CMHP, QIDP)
Entity type:Individual
Prefix:MRS
First Name:BRITTNEY
Middle Name:MARIE
Last Name:WEDGE
Suffix:
Gender:F
Credentials:CMHP, QIDP
Other - Prefix:MISS
Other - First Name:BRITTNEY
Other - Middle Name:MARIE
Other - Last Name:DEMANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:540 JENNER DR
Mailing Address - Street 2:
Mailing Address - City:ALLEGAN
Mailing Address - State:MI
Mailing Address - Zip Code:49010-1517
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:540 JENNER DR
Practice Address - Street 2:
Practice Address - City:ALLEGAN
Practice Address - State:MI
Practice Address - Zip Code:49010-1517
Practice Address - Country:US
Practice Address - Phone:269-355-0243
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-23
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician