Healthcare Provider Details

I. General information

NPI: 1386558559
Provider Name (Legal Business Name): BREANNA MADELYN NADU MS, LBS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

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

III. Provider practice location address

825 EDEN RD
LANCASTER PA
17601-4713
US

IV. Provider business mailing address

308 NEW HOLLAND AVE
LANCASTER PA
17602-2301
US

V. Phone/Fax

Practice location:
  • Phone: 717-406-7393
  • Fax:
Mailing address:
  • Phone: 717-406-7393
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberAA0007264627
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: