Provider Demographics
NPI:1750955712
Name:WARNER, BRITTANY GRACE
Entity type:Individual
Prefix:MISS
First Name:BRITTANY
Middle Name:GRACE
Last Name:WARNER
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 1:749 CLINTON ST
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45315-9763
Mailing Address - Country:US
Mailing Address - Phone:937-708-1051
Mailing Address - Fax:
Practice Address - Street 1:1628 E DOROTHY LN
Practice Address - Street 2:
Practice Address - City:KETTERING
Practice Address - State:OH
Practice Address - Zip Code:45429-3810
Practice Address - Country:US
Practice Address - Phone:937-365-7455
Practice Address - Fax:937-600-6071
Is Sole Proprietor?:No
Enumeration Date:2021-05-14
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH106S00000X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No171M00000XOther Service ProvidersCase Manager/Care Coordinator