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Individual

MS. BREANNA LAND

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
6000 US-98, PENSACOLA, FL 32512-2111
(757) 289-2348
Mailing address
6000 US-98, PENSACOLA, FL 32503
(757) 289-2348

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
0810007404
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
NONE
NONE
Enumeration date
12/09/2019
Last updated
11/08/2023
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