Provider Demographics
NPI:1932337425
Name:YORTY, BRANDON D (BCBA)
Entity Type:Individual
Prefix:MR
First Name:BRANDON
Middle Name:D
Last Name:YORTY
Suffix:
Gender:M
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6071 PEACH TREE ST
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17111-4729
Mailing Address - Country:US
Mailing Address - Phone:717-572-0701
Mailing Address - Fax:
Practice Address - Street 1:6071 PEACH TREE ST
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17111-4729
Practice Address - Country:US
Practice Address - Phone:717-572-0701
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-23
Last Update Date:2009-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA1-06-3073103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst