MEDICARE: MRS. SHAWNA ANN BRETHOUWER MA, BEHAVIOR ANALYST

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1720911449
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SHAWNA ANN BRETHOUWER MA, BEHAVIOR ANALYST

Provider Business Mailing Address
First Line	:	1701 DORSEY ST
Second Line	:
City	:	BEATRICE
State	:	NE
Zip	:	68310-1727
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1701 DORSEY ST
Second Line	:
City	:	BEATRICE
State	:	NE
Zip	:	68310-1727
Country	:	US
Telephone Number	:	402-988-8438
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/03/2026
Last Update Date	:	06/03/2026

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