Healthcare Provider Details
I. General information
NPI: 1730509951
Provider Name (Legal Business Name): WILLIAM BRANDON KLEIN M.ED., BCBA, LABA
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/27/2014
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
302 S SPRING ST
TUPELO MS
38804-4822
US
IV. Provider business mailing address
PO BOX 68
TUPELO MS
38802-0068
US
V. Phone/Fax
- Phone: 662-205-0098
- Fax: 662-495-4079
- Phone: 662-205-0098
- Fax: 662-495-4079
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363A00000X |
| Taxonomy | Physician Assistant |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 183700000X |
| Taxonomy | Pharmacy Technician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: