Provider Demographics
NPI:1922461516
Name:HEINL, BRIELLE (BCBA, LBA)
Entity Type:Individual
Prefix:
First Name:BRIELLE
Middle Name:
Last Name:HEINL
Suffix:
Gender:F
Credentials:BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 PUTNEY DR
Mailing Address - Street 2:
Mailing Address - City:WEST HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06516-2931
Mailing Address - Country:US
Mailing Address - Phone:203-814-7236
Mailing Address - Fax:
Practice Address - Street 1:57 W TOWN ST
Practice Address - Street 2:2E
Practice Address - City:MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06460-3297
Practice Address - Country:US
Practice Address - Phone:203-814-7236
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-31
Last Update Date:2023-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst