Provider Demographics
NPI:1588185805
Name:COLLINS, BRANDY N (BCBA)
Entity Type:Individual
Prefix:MRS
First Name:BRANDY
Middle Name:N
Last Name:COLLINS
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:413 E LITTLE DIPPER
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76542-6427
Mailing Address - Country:US
Mailing Address - Phone:808-393-3973
Mailing Address - Fax:
Practice Address - Street 1:1200 E STAN SCHLUETER LOOP
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76542-5481
Practice Address - Country:US
Practice Address - Phone:808-393-3973
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-28
Last Update Date:2017-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-17-26548103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst