Individual
BREANNA HENES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCABA
Contact information
Practice address
8700 ROLLING BROOK LN, JACKSONVILLE, FL 32256-9024
(904) 534-6935
Mailing address
12633 AVERY HILL CT, JACKSONVILLE, FL 32225-5995
(734) 883-8688
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
02011328
FL
106S00000X
Behavior Technician
—
—
Other
Enumeration date
08/17/2020
Last updated
05/16/2022
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