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General NPI Number Information
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NPI Number | 1427933100
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Entity Type | Individual
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Provider Name | AILYSSA BRIMER
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Gender | Female
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Dates
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Enumeration Date | 08/11/2025
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Last Update Date | 08/11/2025
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Provider Practice Location Address
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Address Line | 3920 WOODLAND HEIGHTS RD
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City | LITTLE ROCK
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State | AR
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Zip | 72212-2495
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Country | US
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Telephone | 501-951-0808
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Fax |
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Provider Business Mailing Address
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Address Line | 103 LEXINGTON CT
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City | JACKSONVILLE
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State | AR
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Zip | 72076-3321
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Country | US
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Telephone | 501-254-1016
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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 | BCBA1333656
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License Number State | AR
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