Provider Demographics
NPI:1558889154
Name:BERRIE, TRENTON TELL (BCBA)
Entity Type:Individual
Prefix:
First Name:TRENTON
Middle Name:TELL
Last Name:BERRIE
Suffix:
Gender:M
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 250
Mailing Address - Street 2:
Mailing Address - City:BROWNWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:76804-0250
Mailing Address - Country:US
Mailing Address - Phone:325-646-9574
Mailing Address - Fax:
Practice Address - Street 1:408 MULBERRY
Practice Address - Street 2:
Practice Address - City:BROWNWOOD
Practice Address - State:TX
Practice Address - Zip Code:76801-5058
Practice Address - Country:US
Practice Address - Phone:325-234-0421
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-03
Last Update Date:2021-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst