Provider Demographics
NPI:1184196735
Name:RIOS-ROBLES, BRIANNA (MA, BCBA)
Entity Type:Individual
Prefix:
First Name:BRIANNA
Middle Name:
Last Name:RIOS-ROBLES
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:651 E 10TH DR
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85204-4115
Mailing Address - Country:US
Mailing Address - Phone:520-837-9114
Mailing Address - Fax:
Practice Address - Street 1:651 E 10TH DR
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85204-4115
Practice Address - Country:US
Practice Address - Phone:520-837-9114
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-20
Last Update Date:2021-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRBT-18-53003106S00000X
AZ103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician