MEDICARE: BRITTANY BRODEUR

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	106S00000X	Behavior Technician	1732997	FL
2	106E00000X	Assistant Behavior Analyst	0-19-10035	FL
3	103K00000X	Behavior Analyst	1-25-83280	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0-19-10035	OTHER	FL	BCABA
2	1-25-83180	OTHER	TX	BCBA
3	17-32997	OTHER	FL	RBT
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1366977274
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRITTANY BRODEUR

Provider Business Mailing Address
First Line	:	700 E 11TH ST APT 708
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78701-1075
Country	:	US
Telephone Number	:	321-419-5046
Fax Number	:

Provider Business Practice Location Address
First Line	:	700 E 11TH ST APT 708
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78701-1075
Country	:	US
Telephone Number	:	321-419-5046
Fax Number	:

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

Provider Enumeration Date	:	04/28/2017
Last Update Date	:	03/03/2026

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Directions to “ BRITTANY BRODEUR ” Practice Location

Language	Start Address	Practice Location

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