Provider Demographics
NPI:1225578370
Name:UNLOCKING BEHAVIOR CHANGE, LLC
Entity Type:Organization
Organization Name:UNLOCKING BEHAVIOR CHANGE, LLC
Other - Org Name:JENNIFER BREDTHAUER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:LYN
Authorized Official - Last Name:BREDTHAUER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, BCBA-D
Authorized Official - Phone:334-332-5716
Mailing Address - Street 1:3000 LONG BRANCH DR
Mailing Address - Street 2:
Mailing Address - City:CALERA
Mailing Address - State:AL
Mailing Address - Zip Code:35040-5332
Mailing Address - Country:US
Mailing Address - Phone:334-332-5716
Mailing Address - Fax:
Practice Address - Street 1:3000 LONG BRANCH DR
Practice Address - Street 2:
Practice Address - City:CALERA
Practice Address - State:AL
Practice Address - Zip Code:35040-5332
Practice Address - Country:US
Practice Address - Phone:334-332-5716
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-07
Last Update Date:2017-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center