Provider Demographics
NPI:1356094197
Name:YELLOW BRICK ACADEMY
Entity Type:Organization
Organization Name:YELLOW BRICK ACADEMY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BRANDT
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, BCBA-D, LBA-WI
Authorized Official - Phone:715-514-2555
Mailing Address - Street 1:1620 OHM AVE
Mailing Address - Street 2:
Mailing Address - City:EAU CLAIRE
Mailing Address - State:WI
Mailing Address - Zip Code:54701-4611
Mailing Address - Country:US
Mailing Address - Phone:715-514-2555
Mailing Address - Fax:
Practice Address - Street 1:1620 OHM AVE
Practice Address - Street 2:
Practice Address - City:EAU CLAIRE
Practice Address - State:WI
Practice Address - Zip Code:54701-4611
Practice Address - Country:US
Practice Address - Phone:715-514-2555
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-01
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty