Breanna Sullins

Individual provider Active NPI Behavior Analyst · Efland, NC

NPI 1992172118 · NPPES record last updated Jan 17, 2020

Key facts

NPI
1992172118
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Analyst 103K00000X
License
BACB293460 (NC)
Practice address
4634 Harmony LN
Efland, NC 27243-9456
Phone
(919) 742-0919
NPI assigned
Aug 24, 2015
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
BACB293460NCMDBehavioral Analyst

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X BACB293460 NC Yes

Addresses

Primary practice location

4634 Harmony LN
Efland, NC 27243-9456

Mailing address

4634 Harmony LN
Efland, NC 27243-9456
Phone (919) 742-0919

Other practice location 1

500 Fairway Dr Ste 102
Deerfield Beach, FL 33441-1817
Phone (888) 880-9270

Other providers in Efland, NC

All providers in Efland, NC · Behavior Analyst in North Carolina

Sources for this page

Verify at the official NPI Registry.