Individual
BREON CORNELIUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, BCBA
Contact information
Practice address
703 ATLANTA RD, CUMMING, GA 30040-2705
(770) 886-6204
(678) 261-6421
Mailing address
1389 WEBER INDUSTRIAL DR, CUMMING, GA 30041-6468
(770) 886-6204
(678) 261-6421
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-19-40348
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-19-40348
BACB
—
Enumeration date
01/03/2020
Last updated
01/03/2020
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