Provider Demographics
NPI:1588298269
Name:JONES, BRANDY MARTINA (BCBA)
Entity type:Individual
Prefix:
First Name:BRANDY
Middle Name:MARTINA
Last Name:JONES
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9105 LIPTONSHIRE DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75238-2713
Mailing Address - Country:US
Mailing Address - Phone:907-830-1694
Mailing Address - Fax:
Practice Address - Street 1:9105 LIPTONSHIRE DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75238-2713
Practice Address - Country:US
Practice Address - Phone:907-830-1694
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-02
Last Update Date:2024-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-20-41370103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst