Provider Demographics
NPI:1730509951
Name:KLEIN, WILLIAM BRANDON (MED, BCBA, LABA)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:BRANDON
Last Name:KLEIN
Suffix:
Gender:
Credentials:MED, BCBA, LABA
Other - Prefix:
Other - First Name:WILLIAM
Other - Middle Name:BRANDON
Other - Last Name:KLEIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MED, BCBA, LABA
Mailing Address - Street 1:143C WILLOWBROOK DR
Mailing Address - Street 2:
Mailing Address - City:SALTILLO
Mailing Address - State:MS
Mailing Address - Zip Code:38866-6896
Mailing Address - Country:US
Mailing Address - Phone:662-205-0098
Mailing Address - Fax:662-495-4079
Practice Address - Street 1:143C WILLOWBROOK DR
Practice Address - Street 2:
Practice Address - City:SALTILLO
Practice Address - State:MS
Practice Address - Zip Code:38866-6896
Practice Address - Country:US
Practice Address - Phone:662-205-0098
Practice Address - Fax:662-495-4079
Is Sole Proprietor?:No
Enumeration Date:2014-04-27
Last Update Date:2025-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
183700000X, 103K00000X
1-16-23320103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No183700000XPharmacy Service ProvidersPharmacy Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL017418000Medicaid
FL016524900Medicaid
FL016685300Medicaid
FL020074500Medicaid