Individual
BREANNA MORAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
321 W WALNUT ST STE 2, JOHNSON CITY, TN 37604-6774
(423) 202-3622
Mailing address
321 W WALNUT ST STE 2, JOHNSON CITY, TN 37604-6774
(423) 202-3622
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
TN
Other
Enumeration date
11/02/2022
Last updated
11/02/2022
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