Provider Demographics
NPI:1760830699
Name:RAGOSTA, BRIANNA MARIE (MS, BCBA)
Entity Type:Individual
Prefix:MISS
First Name:BRIANNA
Middle Name:MARIE
Last Name:RAGOSTA
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:BRIANNA
Other - Middle Name:MARIE
Other - Last Name:CODERRE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4620 N STATE ROAD 7 STE 300
Mailing Address - Street 2:
Mailing Address - City:LAUDERDALE LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33319-5867
Mailing Address - Country:US
Mailing Address - Phone:561-227-9814
Mailing Address - Fax:
Practice Address - Street 1:1645 SE PORT ST LUCIE BLVD
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34952-5428
Practice Address - Country:US
Practice Address - Phone:877-591-1888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-01
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT147.0119868103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst