Provider Demographics
NPI:1528464872
Name:EVANS, BRITTANY (MA, BCBA)
Entity type:Individual
Prefix:MRS
First Name:BRITTANY
Middle Name:
Last Name:EVANS
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:BRITTANY
Other - Middle Name:
Other - Last Name:SORTINO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2065 POLLOCK RD
Mailing Address - Street 2:
Mailing Address - City:DELAWARE
Mailing Address - State:OH
Mailing Address - Zip Code:43015-3154
Mailing Address - Country:US
Mailing Address - Phone:972-849-5584
Mailing Address - Fax:
Practice Address - Street 1:2065 POLLOCK RD
Practice Address - Street 2:
Practice Address - City:DELAWARE
Practice Address - State:OH
Practice Address - Zip Code:43015-3154
Practice Address - Country:US
Practice Address - Phone:972-849-5584
Practice Address - Fax:614-682-8710
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-14
Last Update Date:2024-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1-16-21954103K00000X, 103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0457277Medicaid
OHCOBA.00896OtherOH COBA
TX2074OtherBCBA STATE LICENSE