Provider Demographics
NPI:1912515925
Name:FARRELL, BRIANNA LYNN (BCBA)
Entity Type:Individual
Prefix:
First Name:BRIANNA
Middle Name:LYNN
Last Name:FARRELL
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 1:407 7TH AVE APT 22
Mailing Address - Street 2:
Mailing Address - City:ASBURY PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07712-5431
Mailing Address - Country:US
Mailing Address - Phone:973-534-0137
Mailing Address - Fax:
Practice Address - Street 1:407 7TH AVE
Practice Address - Street 2:APT 22
Practice Address - City:ASBURY PARK
Practice Address - State:N/A
Practice Address - Zip Code:07712
Practice Address - Country:US
Practice Address - Phone:973-534-0137
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-15
Last Update Date:2022-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty