Individual
BRIAN TANENBAUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BCBA
Contact information
Practice address
2808 MCKINNEY AVE, APT. 640, DALLAS, TX 75204-8603
(214) 789-1387
Mailing address
2808 MCKINNEY AVE, APT. 640, DALLAS, TX 75204-8603
(214) 789-1387
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-15-18571
CA
Other
Enumeration date
05/01/2015
Last updated
08/18/2016
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