Basic Information
Provider Information
NPI: 1396233508
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TRUEHEART
FirstName: BRIANA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: RBT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: FISHER
OtherFirstName: BRIANA
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: 11820 CYPRESS CORNER LN
Address2:  
City: HOUSTON
State: TX
PostalCode: 770651132
CountryCode: US
TelephoneNumber: 2818941423
FaxNumber:  
Practice Location
Address1: 11820 CYPRESS CORNER LN
Address2:  
City: HOUSTON
State: TX
PostalCode: 770651132
CountryCode: US
TelephoneNumber: 2818941423
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/24/2018
LastUpdateDate: 07/23/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/23/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
106S00000X  Y    

ID Information
IDTypeStateIssuerDescription
RBT-18-5012901 BEHAVIOR ANALYST CERTIFICATION BOARDOTHER


Home