Healthcare Provider Details

I. General information

NPI: 1326687542
Provider Name (Legal Business Name): BRIAN TUTINO M.S.,BCBA, LABA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/06/2020
Last Update Date: 04/13/2023
Certification Date: 04/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

80 PALOMINO LN STE 201
BEDFORD NH
03110-6447
US

IV. Provider business mailing address

560 VILLAGE BLVD STE 100
WEST PALM BEACH FL
33409-1963
US

V. Phone/Fax

Practice location:
  • Phone: 603-933-0522
  • Fax:
Mailing address:
  • Phone: 561-335-5681
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number2785
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: