Organization
BRIGHTWATER BEHAVIOR ANALYSIS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JARED E MILLER (CEO)
(352) 422-5452
Entity
Organization
Contact information
Practice address
4860 S PRICES PT, HOMOSASSA, FL 34448-3740
(352) 422-5452
Mailing address
PO BOX 584, HOMOSASSA, FL 34487-0584
(352) 422-5452
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
106E00000X
Assistant Behavior Analyst
—
—
106S00000X
Behavior Technician
—
—
Other
Enumeration date
08/21/2023
Last updated
02/17/2024
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