Individual
BREANNA PORTWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
191 JOHN GODLEY LN, ELLABELL, GA 31308-8076
(770) 870-0770
Mailing address
191 JOHN GODLEY LN, ELLABELL, GA 31308-8076
(770) 870-0770
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
03/21/2023
Last updated
10/19/2025
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