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Individual

BRADI R ROGERS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
3841 SAGEBRIAR DR, BRYAN, TX 77802-6107
(210) 447-0039
Mailing address
6222 W IH 10 STE 104, SAN ANTONIO, TX 78201-2013
(210) 447-0039

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
4530
TX
106S00000X
Behavior Technician

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1-21-54131
BEHAVIOR ANALYST CERTIFICATION BOARD
Enumeration date
12/07/2020
Last updated
03/29/2022
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