Healthcare Provider Details

I. General information

NPI: 1508646266
Provider Name (Legal Business Name): BREANNA LYNN CABANISS BCBA, LBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2023
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7500 W 161ST ST
STILWELL KS
66085-9387
US

IV. Provider business mailing address

9153 W 133RD ST
OVERLAND PARK KS
66213-4333
US

V. Phone/Fax

Practice location:
  • Phone: 913-257-5185
  • Fax:
Mailing address:
  • Phone: 913-257-5185
  • Fax: 833-340-7117

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: