Healthcare Provider Details

I. General information

NPI: 1548987019
Provider Name (Legal Business Name): BRYANNA LYNN STEPHENS RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/25/2022
Last Update Date: 10/25/2022
Certification Date: 10/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

820 S UNIVERSITY BLVD STE 2F
MOBILE AL
36609-7860
US

IV. Provider business mailing address

1500 HILLCREST RD APT 1236
MOBILE AL
36695-3965
US

V. Phone/Fax

Practice location:
  • Phone: 251-340-2020
  • Fax: 251-973-8201
Mailing address:
  • Phone: 414-550-9931
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-22-235351
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: