Healthcare Provider Details

I. General information

NPI: 1134040629
Provider Name (Legal Business Name): JAMES CURTIS BREAUX JR.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7850 RIVERS AVE
N CHARLESTON SC
29406-4016
US

IV. Provider business mailing address

7850 RIVERS AVE
N CHARLESTON SC
29406-4016
US

V. Phone/Fax

Practice location:
  • Phone: 843-588-5677
  • Fax: 855-632-2877
Mailing address:
  • Phone: 843-588-5677
  • Fax: 855-632-2877

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-25-479750
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: