Provider Demographics
NPI:1679061543
Name:BARTLETT, BRITTANY LEE (RBT)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:LEE
Last Name:BARTLETT
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3607 PEBBLE HILL DR
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30062-1178
Mailing Address - Country:US
Mailing Address - Phone:770-757-4628
Mailing Address - Fax:
Practice Address - Street 1:4994 LOWER ROSWELL RD STE 10
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30068-4332
Practice Address - Country:US
Practice Address - Phone:770-565-3045
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-26
Last Update Date:2018-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARBT-18-54268106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty