Provider Demographics
NPI:1760212542
Name:KUZNIAR, BRITTAY MICHELLE (QMHP-CS-BA)
Entity type:Individual
Prefix:
First Name:BRITTAY
Middle Name:MICHELLE
Last Name:KUZNIAR
Suffix:
Gender:F
Credentials:QMHP-CS-BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8915 HARRY HINES BLVD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75235-1717
Mailing Address - Country:US
Mailing Address - Phone:682-760-5508
Mailing Address - Fax:
Practice Address - Street 1:319 N 12TH ST STE I
Practice Address - Street 2:
Practice Address - City:CORSICANA
Practice Address - State:TX
Practice Address - Zip Code:75110-4604
Practice Address - Country:US
Practice Address - Phone:903-270-0885
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-06
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172V00000XOther Service ProvidersCommunity Health WorkerGroup - Multi-Specialty