Healthcare Provider Details

I. General information

NPI: 1720537376
Provider Name (Legal Business Name): BRANDI M HABINA BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MS. BRANDI M BEHNKE

II. Dates (important events)

Enumeration Date: 09/23/2016
Last Update Date: 01/27/2025
Certification Date: 01/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 MARCUS DR STE 308
GREENVILLE SC
29615-6946
US

IV. Provider business mailing address

PO BOX 931142
ATLANTA GA
31193-1142
US

V. Phone/Fax

Practice location:
  • Phone: 864-631-2084
  • Fax: 803-905-4427
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number000800-1
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-14-17870
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: