Raven, Brittany
Raven, Brittany is an individual health care provider with primary practice located at 9532 E 16 Frontage Rd , Onalaska WI 54650-6739. She recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as her primary health care specialty. Raven, Brittany can be contacted via phone (608) 783-0506.Contact Information
Primary practice address
9532 E 16 Frontage Rd
Onalaska WI 54650-6739
Phone: (608) 783-0506
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | 19106130 | Wisconsin |
Profile Details
| NPI number | 1265022008 |
|---|---|
| LBN Legal business name | Raven, Brittany |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 26th, 2021 |
| Last updated | Jan 26th, 2021 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1265022008 | NPPES |
| Wisconsin | MEDICAID | 1003150004 |
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