Breanna Henson, BCBA
Individual provider Active NPI Behavior Analyst · Wildwood, MO
NPI 1558080119 · NPPES record last updated Aug 25, 2022
Key facts
- NPI
- 1558080119
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Analyst 103K00000X
- Practice address
- 16375 Pierside LN
Wildwood, MO 63040-1600 - Phone
- (636) 405-2701
- NPI assigned
- Aug 25, 2022
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Howard Park Early Intervention Center | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | Yes |
Addresses
Primary practice location
16375 Pierside LN
Wildwood, MO 63040-1600
Mailing address
3107 Ridgewood Hills Dr
Farmington, MO 63640-7758
Phone (573) 701-5236
Other providers in Wildwood, MO
- Healing Hour LLC
- Healthy Healing Chiropractic LLC
- Jamie Heimos
- Anastasia Leigh Henning
- Nickie Henry
- Luke Herbst
- Melissa Anne Hodge
- Steven Ice
- Idim
- Illinois Rural Healthcare
All providers in Wildwood, MO · Behavior Analyst in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 25, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.