Provider Demographics
NPI:1689903080
Name:LINENS, BRENN BURCH (BCBA)
Entity Type:Individual
Prefix:
First Name:BRENN
Middle Name:BURCH
Last Name:LINENS
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 1:105 W CORBIN ST STE 204
Mailing Address - Street 2:
Mailing Address - City:HILLSBOROUGH
Mailing Address - State:NC
Mailing Address - Zip Code:27278-2192
Mailing Address - Country:US
Mailing Address - Phone:919-742-0919
Mailing Address - Fax:
Practice Address - Street 1:105 W CORBIN ST STE 204
Practice Address - Street 2:
Practice Address - City:HILLSBOROUGH
Practice Address - State:NC
Practice Address - Zip Code:27278-2192
Practice Address - Country:US
Practice Address - Phone:919-742-0919
Practice Address - Fax:984-217-0009
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-14
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC184103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst