Provider Demographics
NPI:1902594203
Name:TRAVARCA, BRITTANY ANN (PSYM, BCBA, COBA)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:ANN
Last Name:TRAVARCA
Suffix:
Gender:F
Credentials:PSYM, BCBA, COBA
Other - Prefix:
Other - First Name:BRITTANY
Other - Middle Name:ANN
Other - Last Name:FORTKAMP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYM, BCBA, COBA
Mailing Address - Street 1:2427 LARCHMONT DR
Mailing Address - Street 2:
Mailing Address - City:WICKLIFFE
Mailing Address - State:OH
Mailing Address - Zip Code:44092-2441
Mailing Address - Country:US
Mailing Address - Phone:440-525-0703
Mailing Address - Fax:
Practice Address - Street 1:2427 LARCHMONT DR
Practice Address - Street 2:
Practice Address - City:WICKLIFFE
Practice Address - State:OH
Practice Address - Zip Code:44092-2441
Practice Address - Country:US
Practice Address - Phone:440-525-0703
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-26
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH103K00000X
OH1-22-59302103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst