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General NPI Number Information
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NPI Number | 1497429484
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Entity Type | Individual
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Provider Name | BRIANNA GABRIEL DE ANDA
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Gender | Female
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Dates
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Enumeration Date | 08/04/2021
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Last Update Date | 07/04/2025
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Provider Practice Location Address
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Address Line | 4200 W CYPRESS ST STE 550
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City | TAMPA
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State | FL
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Zip | 33607-4285
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Country | US
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Telephone | 866-468-6471
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Fax |
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Provider Business Mailing Address
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Address Line | 2271 CENTER ST
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City | HONOLULU
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State | HI
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Zip | 96818-2613
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Country | US
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Telephone | 510-909-3915
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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 | HI
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