Individual
BRANDI TAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.ED., BCBA
Contact information
Practice address
41951 REMINGTON AVE, SUITE 210, TEMECULA, CA 92591
(951) 813-4034
(951) 813-4035
Mailing address
40485 MURRIETA HOT SPRINGS RD, B-4, #146, MURRIETA, CA 92563-6436
(951) 813-4034
(951) 813-4035
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-14-15639
CA
Other
Enumeration date
05/16/2014
Last updated
07/09/2014
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