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General NPI Number Information
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NPI Number | 1326595539
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Entity Type | Individual
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Provider Name | BRITTANY BOGANSKI BCBA
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Gender | Female
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Dates
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Enumeration Date | 09/06/2016
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Last Update Date | 01/27/2020
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Provider Practice Location Address
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Address Line | 1855 W HIBISCUS BLVD
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City | MELBOURNE
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State | FL
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Zip | 32901-2622
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Country | US
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Telephone | 321-345-4232
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Fax | 321-765-6434
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Provider Business Mailing Address
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Address Line | 125 E NASA BLVD
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City | MELBOURNE
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State | FL
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Zip | 32901-1900
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Country | US
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Telephone | 321-372-6813
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Fax | 321-765-6434
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1616135
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License Number State | FL
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