Individual
BREANNA CHILDERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
203 BURKESVILLE ST STE 101, COLUMBIA, KY 42728-1900
(270) 250-5070
(270) 380-1711
Mailing address
56 PIKE ALY APT 2, JAMESTOWN, KY 42629-2225
(916) 293-6887
(270) 380-1711
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
07/05/2023
Last updated
07/05/2023
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