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Individual
BREONNA MABRY
Active
Individual
BREONNA MABRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA, LBA
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
909
CT
103K00000X
Behavior Analyst
Primary
LBA885
MD
222Q00000X
Developmental Therapist
909
CT
Other
Enumeration date
01/16/2020
Last updated
02/17/2022
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