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General NPI Number Information
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NPI Number | 1568931590
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Entity Type | Individual
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Provider Name | BRANDE SMETANA
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Gender | Female
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Dates
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Enumeration Date | 11/20/2018
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Last Update Date | 01/13/2023
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Provider Practice Location Address
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Address Line | 4131 UNIVERSITY BLVD S STE 15
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City | JACKSONVILLE
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State | FL
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Zip | 32216-4346
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Country | US
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Telephone | 608-797-6009
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Fax |
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Provider Business Mailing Address
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Address Line | 226 TIMBERWOLF DR
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City | MANKATO
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State | MN
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Zip | 56001
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Country | US
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Telephone | 608-520-3046
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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