Individual
BREANNA NICOLE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
21755 I45 N, SPRING, TX 77388-3607
(217) 447-0039
Mailing address
2830 FERN HILL DR, SPRING, TX 77373-4951
(281) 865-1833
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-23-305205
TX
Other
Enumeration date
10/31/2023
Last updated
10/31/2023
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