Provider Demographics
NPI:1649402355
Name:BRINSON, ERICA SARAH (MS, BCBA)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:SARAH
Last Name:BRINSON
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:ERICA
Other - Middle Name:SARAH
Other - Last Name:WERNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, BCBA
Mailing Address - Street 1:6340 GOLDEN EYE GLN
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD RANCH
Mailing Address - State:FL
Mailing Address - Zip Code:34202-5833
Mailing Address - Country:US
Mailing Address - Phone:941-961-4684
Mailing Address - Fax:941-536-0403
Practice Address - Street 1:6340 GOLDEN EYE GLN
Practice Address - Street 2:
Practice Address - City:LAKEWOOD RANCH
Practice Address - State:FL
Practice Address - Zip Code:34202-5833
Practice Address - Country:US
Practice Address - Phone:941-961-4684
Practice Address - Fax:941-536-0403
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-13
Last Update Date:2009-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst