MEDICARE: BRANDON BOWENS RBT

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
1	103K00000X	Behavior Analyst		SC

General Provider Information

NPI Number	:	1922953215
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRANDON BOWENS RBT

Provider Business Mailing Address
First Line	:	440 ROPER MOUNTAIN RD
Second Line	:
City	:	GREENVILLE
State	:	SC
Zip	:	29615-4242
Country	:	US
Telephone Number	:	800-244-4691
Fax Number	:

Provider Business Practice Location Address
First Line	:	440 ROPER MOUNTAIN RD
Second Line	:
City	:	GREENVILLE
State	:	SC
Zip	:	29615-4242
Country	:	US
Telephone Number	:	800-244-4691
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/02/2026
Last Update Date	:	03/02/2026

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