MEDICARE: ANNA KRISTINA BRYAN BCBA

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	1-22-57623	FL

General Provider Information

NPI Number	:	1609727494
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNA KRISTINA BRYAN BCBA

Provider Business Mailing Address
First Line	:	6211 LAKE AVE
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33405
Country	:	US
Telephone Number	:	571-327-9916
Fax Number	:

Provider Business Practice Location Address
First Line	:	6211 LAKE AVE
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33405-3923
Country	:	US
Telephone Number	:	571-327-9916
Fax Number	:

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

Provider Enumeration Date	:	02/06/2026
Last Update Date	:	02/06/2026

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