Individual
BENTLEY REAGAN RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
100 SPENRYN DR, MADISON, AL 35758-1890
(256) 772-4400
Mailing address
110 OAKLAND SPGS UNIT 6306, MADISON, AL 35756-5583
(256) 476-2333
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
BCABA-0-26-16812
AL
106S00000X
Behavior Technician
Primary
RBT-23-286544
AL
Other
Enumeration date
07/24/2023
Last updated
01/16/2026
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