Individual
BREANA LYNN SHIELDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1769 SW PARKWAY DR, REDMOND, OR 97756-2550
(541) 316-5888
Mailing address
1769 SW PARKWAY DR, REDMOND, OR 97756-2550
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
ABA-IN-10253783
OR
Other
Enumeration date
03/24/2025
Last updated
03/24/2025
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