Individual
MRS. BREANNA SUZETTE HALL KNOWLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCABA
Contact information
Practice address
122 LYNNHAVEN DR, WASHINGTON, IL 61571-3323
(719) 688-0218
Mailing address
122 LYNNHAVEN DR, WASHINGTON, IL 61571-3323
(719) 688-0218
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
0-12-5194
—
Other
Enumeration date
11/04/2012
Last updated
11/04/2012
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