| The Brightside Of Behavior | |
|
1616 Veterans Ave Vandalia IL 62471-3317 | |
| (618) 704-1677 | |
| (618) 551-4525 |
| Full Name | The Brightside Of Behavior |
|---|---|
| Speciality | Behavior Analyst |
| Location | 1616 Veterans Ave, Vandalia, Illinois |
| Authorized Official Name and Position | Tanea L Ricketts (OWNER) |
| Authorized Official Contact | 6187041677 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Brightside Of Behavior 1616 Veterans Ave Vandalia IL 62471-3317 Ph: (618) 704-1677 | The Brightside Of Behavior 1616 Veterans Ave Vandalia IL 62471-3317 Ph: (618) 704-1677 |
| NPI Number | 1922755388 |
|---|---|
| Provider Enumeration Date | 03/07/2022 |
| Last Update Date | 03/16/2022 |
| Certification Date | 03/16/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922755388 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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