Provider Demographics
NPI:1144756958
Name:EURE, BRYAN RAYMOND (MED, BCBA)
Entity Type:Individual
Prefix:MR
First Name:BRYAN
Middle Name:RAYMOND
Last Name:EURE
Suffix:
Gender:M
Credentials:MED, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 PENUEL LN
Mailing Address - Street 2:
Mailing Address - City:ALTAVISTA
Mailing Address - State:VA
Mailing Address - Zip Code:24517-4026
Mailing Address - Country:US
Mailing Address - Phone:434-258-2490
Mailing Address - Fax:
Practice Address - Street 1:315 PENUEL LN
Practice Address - Street 2:
Practice Address - City:ALTAVISTA
Practice Address - State:VA
Practice Address - Zip Code:24517-4026
Practice Address - Country:US
Practice Address - Phone:434-258-2490
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0133000940103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst