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NPI Code Detail

MEDICARE: BREANNA LUCRETIA SNIFFEN BCBA

MEDICARE: BREANNA LUCRETIA SNIFFEN BCBA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst1-17-27373CO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1255840419
Entity Type Code : Individual
Provider Name (Legal Business Name) : BREANNA LUCRETIA SNIFFEN BCBA
Provider Business Mailing Address
First Line : 5045 LAKEWALK DR APT 7305
Second Line :
City : WINTER GARDEN
State : FL
Zip : 34787-5738
Country : US
Telephone Number : 407-902-1961
Fax Number :
Provider Business Practice Location Address
First Line : 1000 COLOR PL STE 101
Second Line :
City : APOPKA
State : FL
Zip : 32703-7717
Country : US
Telephone Number : 888-754-0398
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/20/2017
Last Update Date : 08/29/2022

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