Individual
BREANNA GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5340 N TARRANT PKWY, FORT WORTH, TX 76244-6293
(682) 900-1444
(432) 322-4597
Mailing address
5340 N TARRANT PKWY, FORT WORTH, TX 76244-6293
(682) 900-1444
(432) 322-4597
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
09/25/2023
Last updated
06/06/2024
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