Wilson, Breana

Wilson, Breana is an individual health care provider with primary practice located at 5331 Nathan Dr Nw , Lilburn GA 30047-5858. She recently has only one registered license in Behavioral Health & Social Service Providers / Behavioral Analyst, which is considered as her primary health care specialty. Wilson, Breana can be contacted via phone (832) 878-3092.

Contact Information

Primary practice address
5331 Nathan Dr Nw Lilburn GA 30047-5858
Phone: (832) 878-3092
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Behavioral Analyst 103K00000X 37508817 Texas

Profile Details

NPI number 1861966384
LBN Legal business name Wilson, Breana
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 17th, 2019
Last updated Jan 7th, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1861966384 NPPES
Texas MEDICAID 37508817

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