MEDICARE: BRANDON CHARLMAGNE

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

General Provider Information

NPI Number	:	1649133984
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRANDON CHARLMAGNE

Provider Business Mailing Address
First Line	:	1023 BRIARHILL LN NE # 1023
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30324-5428
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1055 HOWELL MILL RD NW
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30318-5557
Country	:	US
Telephone Number	:	404-566-6071
Fax Number	:

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

Provider Enumeration Date	:	12/04/2025
Last Update Date	:	12/04/2025

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Directions to “ BRANDON CHARLMAGNE ” Practice Location

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