Individual
BREANNA UNDERWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3502 BROOKSIDE LN, SLIDELL, LA 70460-3953
(985) 503-8639
Mailing address
3502 BROOKSIDE LN, SLIDELL, LA 70460-3953
(985) 503-8639
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
05/23/2024
Last updated
05/23/2024
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