Individual
BRAD KENNETH BREZINSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BCBA
Contact information
Practice address
1500 N CASALOMA DR STE 306, APPLETON, WI 54913-8220
(920) 205-0475
Mailing address
1500 N CASALOMA DR STE 306, APPLETON, WI 54913-8220
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-19-38874
BEHAVIOR ANALYST CERTIFICATION BOARD
—
Enumeration date
12/23/2019
Last updated
12/23/2019
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