Provider Demographics
NPI:1083354369
Name:STEFFAN, BRYNNE LEIGH (BCBA)
Entity Type:Individual
Prefix:
First Name:BRYNNE
Middle Name:LEIGH
Last Name:STEFFAN
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9865 STATE ROUTE 103
Mailing Address - Street 2:
Mailing Address - City:JENERA
Mailing Address - State:OH
Mailing Address - Zip Code:45841-8952
Mailing Address - Country:US
Mailing Address - Phone:419-721-9799
Mailing Address - Fax:
Practice Address - Street 1:1299 FARNAM ST STE 300
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68102-1857
Practice Address - Country:US
Practice Address - Phone:212-481-4040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-01
Last Update Date:2022-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1-20-42933103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst