Provider Demographics
NPI:1215394028
Name:BEAVER, BRITTANY N (MA, BCBA)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:N
Last Name:BEAVER
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 1:14 STEPHENSON BLVD APT 1
Mailing Address - Street 2:
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10801-4402
Mailing Address - Country:US
Mailing Address - Phone:914-261-2919
Mailing Address - Fax:
Practice Address - Street 1:14 STEPHENSON BLVD APT 1
Practice Address - Street 2:
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10801-4402
Practice Address - Country:US
Practice Address - Phone:914-261-2919
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-25
Last Update Date:2016-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001250103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst