Healthcare Provider Details

I. General information

NPI: 1134301237
Provider Name (Legal Business Name): TERRENCE LYNDELL BRYANT SR. MA, BCBA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/30/2007
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7635 ASHLEY PARK CT STE 503
ORLANDO FL
32835-6196
US

IV. Provider business mailing address

4421 OAKHAM CT
ORLANDO FL
32818-8243
US

V. Phone/Fax

Practice location:
  • Phone: 407-461-1910
  • Fax: 407-297-8870
Mailing address:
  • Phone: 407-461-1910
  • Fax: 407-297-8870

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-01-0543
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: