Provider Demographics
NPI:1588204218
Name:CURTIS, BREANNA LEE (BCBA, LBA)
Entity Type:Individual
Prefix:
First Name:BREANNA
Middle Name:LEE
Last Name:CURTIS
Suffix:
Gender:F
Credentials:BCBA, LBA
Other - Prefix:
Other - First Name:BREANNA
Other - Middle Name:L
Other - Last Name:CURTIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:BREANNA, MS
Mailing Address - Street 1:120 PRECISION STE A-100
Mailing Address - Street 2:
Mailing Address - City:BUDA
Mailing Address - State:TX
Mailing Address - Zip Code:78610-5925
Mailing Address - Country:US
Mailing Address - Phone:512-354-4300
Mailing Address - Fax:
Practice Address - Street 1:50 TRUMBULL ST
Practice Address - Street 2:SUITE 3C
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06103
Practice Address - Country:US
Practice Address - Phone:860-420-9253
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-10
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3175103K00000X
103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst