Provider Demographics
NPI:1346994753
Name:HERRON, BREE (BCBA)
Entity Type:Individual
Prefix:MR
First Name:BREE
Middle Name:
Last Name:HERRON
Suffix:
Gender:M
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9047 E 86TH ST
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46256-1333
Mailing Address - Country:US
Mailing Address - Phone:317-563-6581
Mailing Address - Fax:
Practice Address - Street 1:10475 CROSSPOINT BLVD STE 250
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46256-3387
Practice Address - Country:US
Practice Address - Phone:860-249-1012
Practice Address - Fax:860-955-8693
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-05
Last Update Date:2022-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst