Provider Demographics
NPI:1700778214
Name:THELEN, BRITTANY LYNN
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:LYNN
Last Name:THELEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8760 WALTON BLVD
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48187-4242
Mailing Address - Country:US
Mailing Address - Phone:616-902-2601
Mailing Address - Fax:
Practice Address - Street 1:39650 ORCHARD HILL PL
Practice Address - Street 2:
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48375-5392
Practice Address - Country:US
Practice Address - Phone:248-938-4106
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-18
Last Update Date:2025-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician