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Organization

BRIGHTWATER BEHAVIOR ANALYSIS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JARED E MILLER BCBA (CEO)
(352) 422-5452
Entity
Organization

Contact information

Practice address
4860 S PRICES PT, HOMOSASSA, FL 34448-3740
(352) 422-5452
Mailing address
14099 TROUVILLE DR, TAMPA, FL 33624-6963
(352) 422-5452

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
106E00000X
Assistant Behavior Analyst
106S00000X
Behavior Technician

Other

Enumeration date
08/28/2023
Last updated
10/04/2023
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