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General NPI Number Information
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NPI Number | 1417529322
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Entity Type | Individual
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Provider Name | KENNETH BRAMMER
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Gender | Male
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Dates
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Enumeration Date | 07/12/2021
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Last Update Date | 08/19/2025
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Provider Practice Location Address
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Address Line | 2235 CEDAR LN STE 102
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City | VIENNA
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State | VA
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Zip | 22182-5247
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Country | US
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Telephone | 703-350-8760
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Fax |
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Provider Business Mailing Address
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Address Line | 27777 INKSTER RD STE 100
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City | FARMINGTON HILLS
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State | MI
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Zip | 48334-5312
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Country | US
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Telephone | 248-436-4400
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Fax |
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 106E00000X
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Taxonomy Name | Assistant Behavior Analyst
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License Number | 0134000629
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License Number State | VA
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