MEDICARE: BRANDION SCOTT

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

General Provider Information

NPI Number	:	1932925344
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRANDION SCOTT

Provider Business Mailing Address
First Line	:	290 SAVANNAH AVE NE
Second Line	:
City	:	CLEVELAND
State	:	TN
Zip	:	37312-4859
Country	:	US
Telephone Number	:	423-244-4090
Fax Number	:

Provider Business Practice Location Address
First Line	:	440 STUART RD NE
Second Line	:
City	:	CLEVELAND
State	:	TN
Zip	:	37312-4985
Country	:	US
Telephone Number	:	423-451-4787
Fax Number	:

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

Provider Enumeration Date	:	12/02/2024
Last Update Date	:	12/02/2024

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Directions to “ BRANDION SCOTT ” Practice Location

Language	Start Address	Practice Location

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