Individual
BREANNE GANNAWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
334 VIA VERA CRUZ STE 107, SAN MARCOS, CA 92078-2637
(760) 304-5010
Mailing address
21600 OXNARD ST, WOODLAND HILLS, CA 91367-4976
(818) 345-2345
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
07/02/2018
Last updated
07/02/2018
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