Bryanne Lee Blanton, BCBA, LBA, MS

Individual provider Active NPI Behavior Analyst · Brookfield, WI

NPI 1760985451 · NPPES record last updated May 2, 2023

Key facts

NPI
1760985451
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Analyst 103K00000X
License
1091-140 (WI)
Practice address
150 N Sunny Slope Rd Ste 100
Brookfield, WI 53005-4806
Phone
(262) 432-5660
Fax
(262) 432-5666
NPI assigned
Mar 9, 2018
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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
1091-140WIMDBehavioral Analyst

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1091-140 WI Yes

Addresses

Primary practice location

150 N Sunny Slope Rd Ste 100
Brookfield, WI 53005-4806

Mailing address

N7421 Lost Nation Rd
Elkhorn, WI 53121-2639
Phone (262) 758-7192

Other providers in Brookfield, WI

All providers in Brookfield, WI · Behavior Analyst in Wisconsin

Sources for this page

Verify at the official NPI Registry.