Brynn Bonner

Individual provider Active NPI Behavior Technician · North Augusta, SC

NPI 1730859299 · NPPES record last updated Sep 16, 2021

Key facts

NPI
1730859299
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
License
RBT-21-185079 (SC)
Practice address
714 Carolina Ave
North Augusta, SC 29841-3434
Phone
(706) 842-5330
Fax
(706) 842-5340
NPI assigned
Sep 16, 2021
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
RBT-21-185079SCMDBehavior Technician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X RBT-21-185079 SC Yes

Addresses

Primary practice location

714 Carolina Ave
North Augusta, SC 29841-3434

Mailing address

3736 Executive Center Dr
Augusta, GA 30907-2360
Phone (706) 842-5330

Other providers in North Augusta, SC

All providers in North Augusta, SC · Behavior Technician in South Carolina

Sources for this page

Verify at the official NPI Registry.