Individual
BRIAN DAVID HAGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
454 FORT FLORIDA RD, DEBARY, FL 32713-9714
(610) 755-7620
Mailing address
445 SHADY OAKS DR APT 200, PALM COAST, FL 32164-2551
(610) 755-7520
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-25-83229
FL
106S00000X
Behavior Technician
—
—
Other
Enumeration date
08/09/2022
Last updated
09/11/2025
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