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Individual

LAURA AUBREY BREAULT I

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
BCBA

Contact information

Practice address
1706 11TH AVE APT 3, BROOKLYN, NY 11218-1391
(917) 826-5222
Mailing address
1449 37TH ST, BROOKLYN, NY 11218-4380
(718) 215-5311
(718) 865-5196

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-19-35347
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
630299660
METROPLUS
NY
Enumeration date
04/12/2019
Last updated
02/01/2024
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