Individual
BRADLEY O'BRIEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RBT
Contact information
Practice address
145 E EDGEWOOD DR, LAKELAND, FL 33803-4014
(863) 619-2809
Mailing address
2210 IRENE ST APT D, LUTZ, FL 33549-3119
(813) 955-1517
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
1-23-68623
FL
103K00000X
Behavior Analyst
Primary
—
—
106S00000X
Behavior Technician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102617000
—
FL
Enumeration date
04/20/2020
Last updated
10/03/2023
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