Individual
BREANNE NEWCOMB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A.
Contact information
Practice address
53 BLOOMINGDALE DR, ALEXANDER, NC 28701-9134
(720) 409-6902
Mailing address
53 BLOOMINGDALE DR, ALEXANDER, NC 28701-9134
(720) 409-6902
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
—
222Q00000X
Developmental Therapist
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
252Y00000X
Early Intervention Provider Agency
—
—
Other
Enumeration date
01/28/2015
Last updated
02/19/2015
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