Provider Demographics
NPI:1164723318
Name:LU BREA, ARACELIS JOHANNA (MD)
Entity Type:Individual
Prefix:DR
First Name:ARACELIS
Middle Name:JOHANNA
Last Name:LU BREA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:111 S SPRING ST
Mailing Address - Street 2:
Mailing Address - City:TUPELO
Mailing Address - State:MS
Mailing Address - Zip Code:38804-4817
Mailing Address - Country:US
Mailing Address - Phone:662-432-1221
Mailing Address - Fax:662-432-0699
Practice Address - Street 1:111 S SPRING ST
Practice Address - Street 2:
Practice Address - City:TUPELO
Practice Address - State:MS
Practice Address - Zip Code:38804-4817
Practice Address - Country:US
Practice Address - Phone:662-432-1221
Practice Address - Fax:662-432-0699
Is Sole Proprietor?:No
Enumeration Date:2010-11-04
Last Update Date:2022-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS249712084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry