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Individual

BREANN DONSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2513 W 2ND ST, MARION, IN 46952-3241
(765) 662-0490
Mailing address
3500 DEPAUW BLVD STE 3070, INDIANAPOLIS, IN 46268-6135
(317) 516-6489

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-17-37502

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
RBT-17-37502
RBT CERTIFICATE
Enumeration date
07/23/2019
Last updated
07/23/2019
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