Provider Demographics
NPI:1699106054
Name:TERRENCE BRYANT ENTERPRISES, INC
Entity type:Organization
Organization Name:TERRENCE BRYANT ENTERPRISES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOARD CERTIFIED BEHAVIOR ANALYST
Authorized Official - Prefix:DR
Authorized Official - First Name:TERRENCE
Authorized Official - Middle Name:
Authorized Official - Last Name:BRYANT
Authorized Official - Suffix:SR
Authorized Official - Credentials:PHD, BCBA-D
Authorized Official - Phone:407-461-1910
Mailing Address - Street 1:4421 OAKHAM CT
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32818-8243
Mailing Address - Country:US
Mailing Address - Phone:407-461-1910
Mailing Address - Fax:407-297-8870
Practice Address - Street 1:4421 OAKHAM CT
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32818-8243
Practice Address - Country:US
Practice Address - Phone:407-461-1910
Practice Address - Fax:407-297-8870
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-10
Last Update Date:2013-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health