Provider Demographics
NPI:1649837147
Name:SPRING, BRIGETTE (BCBA)
Entity type:Individual
Prefix:
First Name:BRIGETTE
Middle Name:
Last Name:SPRING
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 1:1772 E APPALOOSA RD
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85296-3232
Mailing Address - Country:US
Mailing Address - Phone:602-622-5917
Mailing Address - Fax:
Practice Address - Street 1:18330 SW DELINE ST
Practice Address - Street 2:
Practice Address - City:ALOHA
Practice Address - State:OR
Practice Address - Zip Code:97078-3814
Practice Address - Country:US
Practice Address - Phone:602-622-5917
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-21
Last Update Date:2020-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRBT-19-80924106S00000X
ORABA-B-10207302103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician