Brayden J Bates
Individual provider Active NPI Behavior Technician · Crestview, FL
NPI 1962220632 · NPPES record last updated Oct 1, 2024
Key facts
- NPI
- 1962220632
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- Practice address
- 296 S Ferdon Blvd
Crestview, FL 32536-3702 - Phone
- (850) 333-1279
- NPI assigned
- Oct 1, 2024
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician |
106S00000X | Yes |
Addresses
Primary practice location
296 S Ferdon Blvd
Crestview, FL 32536-3702
Mailing address
3045 N Commerce Pkwy
Miramar, FL 33025-3927
Phone (786) 953-8500
Other providers in Crestview, FL
- Barnes Healthcare of FL LLC
- Tami Michelle Barnes
- Terence Daniel Barnes
- Andrea Barnhill
- Christine M Bass
- Wanda Cook Batson
- Abigail Coles Beck
- Behealthy Counseling
- Belfiore Wellness Center
- Jessica Danielle Belford
All providers in Crestview, FL · Behavior Technician in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 1, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.