Individual
BREANNA FAYE BROADDUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1009 COMMERCE PARK DR STE 350, OAK RIDGE, TN 37830-8075
(865) 312-8220
(833) 550-1727
Mailing address
PO BOX 32665, KNOXVILLE, TN 37930-2665
(865) 312-8220
(833) 550-1727
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-25-446060
TN
Other
Enumeration date
08/14/2026
Last updated
08/14/2026
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