Provider Demographics
NPI:1770998734
Name:MOSQUEDA, BRITTNEY NICHOLE (LMSW)
Entity type:Individual
Prefix:
First Name:BRITTNEY
Middle Name:NICHOLE
Last Name:MOSQUEDA
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3400 SHATTUCK RD STE 2
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48603-3157
Mailing Address - Country:US
Mailing Address - Phone:989-492-0203
Mailing Address - Fax:
Practice Address - Street 1:3400 SHATTUCK RD STE 2
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48603-3157
Practice Address - Country:US
Practice Address - Phone:989-492-0203
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-27
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010968861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI6801096886OtherSTATE LICENSE