Individual
DAJA BREANA TATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MED, COBA
Contact information
Practice address
18151 JEFFERSON PARK RD, CLEVELAND, OH 44130-3496
(330) 967-0325
(317) 520-8200
Mailing address
3500 DEPAUW BLVD STE 3070, INDIANAPOLIS, IN 46268-6135
(855) 324-0885
(317) 520-8200
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-21-48756
OH
106S00000X
Behavior Technician
RBT-19-92121
OH
Other
Enumeration date
08/04/2020
Last updated
02/23/2026
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