Individual
BREANNA R TACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
225 CEDAR HILL ST STE 200, MARLBOROUGH, MA 01752-5900
(877) 418-2978
Mailing address
500 FAIRWAY DR STE 102, DEERFIELD BEACH, FL 33441-1817
(877) 418-2978
(866) 500-2186
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
09/24/2021
Last updated
09/24/2021
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