Healthcare Provider Details

I. General information

NPI: 1013835529
Provider Name (Legal Business Name): BREANNA MARIE HARPER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

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

III. Provider practice location address

1241 N FRONT ST
PHILADELPHIA PA
19122-4743
US

IV. Provider business mailing address

1701 N 10TH ST
PHILADELPHIA PA
19122-2716
US

V. Phone/Fax

Practice location:
  • Phone: 267-225-8434
  • Fax:
Mailing address:
  • Phone: 443-630-7323
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: