Individual
BRESHONA BREANA SEREAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
296 MERCHANTS SQ, DALLAS, GA 30132-5029
(470) 391-2300
Mailing address
6737 BILL CARRUTH PKWY APT 5223, HIRAM, GA 30141-3782
(678) 767-7475
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-22-212614
GA
Other
Enumeration date
08/22/2022
Last updated
08/22/2022
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