Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst | QASP-S-11956 | FL |
N | 106S00000X | Behavior Technician | RBT-19-87866 | FL |
NPI | 1154989416 |
---|---|
Provider Name | Brandon Mcclelland |
First Address | Navarre, FL 32566-7981 |
Second Address | Navarre, FL 32566-7305 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/06/2019 |
Last Update Date | 02/08/2021 |