Healthcare Provider Details

I. General information

NPI: 1750228813
Provider Name (Legal Business Name): BRIANNA AMARI HUBBARD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2026
Last Update Date: 04/29/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32781 LA 16 S
DENHAM SPRINGS LA
70726
US

IV. Provider business mailing address

31050 LA HIGHWAY 16 APT 1434
DENHAM SPRINGS LA
70726-9014
US

V. Phone/Fax

Practice location:
  • Phone: 225-349-7960
  • Fax:
Mailing address:
  • Phone: 225-575-0641
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number013544979
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: