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NPI Code Detail

MEDICARE: BRITTANY PABALAN BCBA

MEDICARE: BRITTANY PABALAN BCBA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician
2103K00000XBehavior Analyst1-20-40928FL

General Provider Information

NPI Number : 1174031116
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRITTANY PABALAN BCBA
Provider Business Mailing Address
First Line : 67 HIKER ST
Second Line :
City : SANTA ROSA BEACH
State : FL
Zip : 32459-8826
Country : US
Telephone Number : 904-451-1634
Fax Number :
Provider Business Practice Location Address
First Line : 67 HIKER ST
Second Line :
City : SANTA ROSA BEACH
State : FL
Zip : 32459-8826
Country : US
Telephone Number : 904-451-1634
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/11/2018
Last Update Date : 04/11/2020

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Directions to “ BRITTANY PABALAN BCBA” Practice Location

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