Individual
BREANNA MOORE-LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2076 S INDEPENDENCE BLVD STE 1C, VIRGINIA BEACH, VA 23453-4773
(757) 622-7272
Mailing address
1046 TORPEDO WAY, VIRGINIA BEACH, VA 23453-2974
(757) 806-0012
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-24-388023
VA
Other
Enumeration date
11/07/2024
Last updated
11/07/2024
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