Individual
BREANNE ALYSE NICKERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
17170 MILL FOREST RD, WEBSTER, TX 77598-4305
(832) 240-4563
Mailing address
17170 MILL FOREST RD, WEBSTER, TX 77598-4305
(832) 240-4563
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
21152662
TX
Other
Enumeration date
01/26/2021
Last updated
01/26/2021
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