Provider Demographics
NPI:1629533849
Name:BRAVER, ZACHARY (MA, BCBA, LBA)
Entity type:Individual
Prefix:
First Name:ZACHARY
Middle Name:
Last Name:BRAVER
Suffix:
Gender:M
Credentials:MA, BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2121 AMANDA MEADOW CT
Mailing Address - Street 2:
Mailing Address - City:HERMITAGE
Mailing Address - State:TN
Mailing Address - Zip Code:37076-3735
Mailing Address - Country:US
Mailing Address - Phone:443-962-0494
Mailing Address - Fax:
Practice Address - Street 1:2121 AMANDA MEADOW CT
Practice Address - Street 2:
Practice Address - City:HERMITAGE
Practice Address - State:TN
Practice Address - Zip Code:37076-3735
Practice Address - Country:US
Practice Address - Phone:443-962-0494
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-01
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN12369926103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst