NPI 1104293489 · live from the CMS NPI Registry
Brandon Greenstreet, M.A.
Behavior Analyst in Fairbanks, AK. National Provider Identifier 1104293489, active.
NPI record
| NPI | 1104293489 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Behavior Analyst 103K00000X |
| Practice location | 724 27th Ave Ste 2, Fairbanks, AK 99701 |
| Practice phone | 907-374-2905 |
| Enumerated | August 21, 2015 |
| Last updated | September 24, 2020 |
| Sole proprietor | No |
| Other names | Tundra Greenstreet |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Counselor, Mental Health | 101YM0800X | — |
| Behavior Analyst primary | 103K00000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.