Healthcare Provider Details

I. General information

NPI: 1689072118
Provider Name (Legal Business Name): BREANNA LAMOUREUX M.S., BCBA, LABA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/16/2014
Last Update Date: 04/03/2026
Certification Date: 04/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

417 LIBERTY ST
SPRINGFIELD MA
01104-3736
US

IV. Provider business mailing address

22 WEST ST
WEST BROOKFIELD MA
01585-3247
US

V. Phone/Fax

Practice location:
  • Phone: 774-200-3447
  • Fax:
Mailing address:
  • Phone: 774-200-3447
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberLABA2538
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: