Healthcare Provider Details

I. General information

NPI: 1548175094
Provider Name (Legal Business Name): BRACHA TOBA FRIEDMAN BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2026
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6317 N CALIFORNIA AVE
CHICAGO IL
60659-1701
US

IV. Provider business mailing address

2915 W COYLE AVE
CHICAGO IL
60645-2923
US

V. Phone/Fax

Practice location:
  • Phone: 773-465-8889
  • Fax:
Mailing address:
  • Phone: 773-867-0798
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-26-2832450
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: