MEDICARE: BRANDI MARIE WARREN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst	LBA1802	MD
2	103K00000X	Behavior Analyst	0133001063	VA

General Provider Information

NPI Number	:	1285130591
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRANDI MARIE WARREN

Provider Business Mailing Address
First Line	:	1500 S DOUGLAS RD STE 230
Second Line	:
City	:	CORAL GABLES
State	:	FL
Zip	:	33134-4108
Country	:	US
Telephone Number	:	844-244-1818
Fax Number	:

Provider Business Practice Location Address
First Line	:	611 W JUBAL EARLY DR STE C
Second Line	:
City	:	WINCHESTER
State	:	VA
Zip	:	22601-6501
Country	:	US
Telephone Number	:	540-495-1498
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/04/2018
Last Update Date	:	06/03/2024

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Directions to “ BRANDI MARIE WARREN ” Practice Location

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