Provider Demographics
NPI:1164072781
Name:PINO, BRYANNA E (MA, BCBA)
Entity type:Individual
Prefix:
First Name:BRYANNA
Middle Name:E
Last Name:PINO
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:407 S HAZEL ST
Mailing Address - Street 2:
Mailing Address - City:VAN METER
Mailing Address - State:IA
Mailing Address - Zip Code:50261-9713
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:407 S HAZEL ST
Practice Address - Street 2:
Practice Address - City:VAN METER
Practice Address - State:IA
Practice Address - Zip Code:50261-9713
Practice Address - Country:US
Practice Address - Phone:505-730-9738
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-16
Last Update Date:2025-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician