Organization
BRADY BEHAVIOR ANALYSIS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN BRADY MS, BCBA (DIRECTOROF ABA)
(925) 752-2119
Entity
Organization
Contact information
Practice address
11865 WEXFORD CLUB DR, ROSWELL, GA 30075-1471
(925) 752-2119
Mailing address
11865 WEXFORD CLUB DR, ROSWELL, GA 30075-1471
(925) 752-2119
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
1-15-21048
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1225584220
NPI TYPE 1
—
Enumeration date
09/25/2017
Last updated
07/21/2022
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