Provider Demographics
NPI:1750887956
Name:FREEMAN, BRANDI NICOLE (BCBA)
Entity type:Individual
Prefix:
First Name:BRANDI
Middle Name:NICOLE
Last Name:FREEMAN
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 1:625 W CENTERVILLE RD STE 120
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75041-5428
Mailing Address - Country:US
Mailing Address - Phone:214-853-3506
Mailing Address - Fax:
Practice Address - Street 1:625 W CENTERVILLE RD
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75041-5456
Practice Address - Country:US
Practice Address - Phone:972-905-5257
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-05
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1099103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst