Individual
BRIAN JAMES WOHLWEND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BCBA, M.ED
Contact information
Practice address
12205 WILDBROOK DR, RIVERVIEW, FL 33569-4111
(813) 748-2477
Mailing address
12205 WILDBROOK DR, RIVERVIEW, FL 33569-4111
(813) 748-2477
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-12-10015
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-12-10015
BOARD CERTIFIED BEHAVIOR ANALYST
—
Enumeration date
03/26/2018
Last updated
06/16/2018
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