Individual
BRENDEN TYLER PHELPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BCBA 1-26-2835837
Contact information
Practice address
2990 N PERRYVILLE RD UNIT 1100, ROCKFORD, IL 61107-6827
(815) 469-1500
Mailing address
9500 BORMET DR STE 304, MOKENA, IL 60448-8399
(815) 469-1500
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
IL
106S00000X
Behavior Technician
Primary
RBT-18-69560
IL
Other
Enumeration date
11/01/2018
Last updated
08/07/2026
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