Individual
BREAUNA REANN COPELAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6067 DECATUR BLVD, INDIANAPOLIS, IN 46241-9606
(463) 203-3389
Mailing address
6067 DECATUR BLVD, INDIANAPOLIS, IN 46241-9606
(463) 203-3389
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-22-228123
IN
Other
Enumeration date
10/18/2023
Last updated
10/18/2023
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