Provider Demographics
NPI:1336853589
Name:GRACIA, BRITTNEY ANN (BCBA, LBA)
Entity Type:Individual
Prefix:MRS
First Name:BRITTNEY
Middle Name:ANN
Last Name:GRACIA
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 1:21 CRISSEY LN
Mailing Address - Street 2:
Mailing Address - City:SOUTHINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06489-2302
Mailing Address - Country:US
Mailing Address - Phone:203-843-0564
Mailing Address - Fax:
Practice Address - Street 1:21 CRISSEY LN
Practice Address - Street 2:
Practice Address - City:SOUTHINGTON
Practice Address - State:CT
Practice Address - Zip Code:06489-2302
Practice Address - Country:US
Practice Address - Phone:203-843-0564
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-12
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT451103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst