MEDICARE: RICHARD BREUNER

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
1	103K00000X	Behavior Analyst	1-19-35745	NV

General Provider Information

NPI Number	:	1386105450
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICHARD BREUNER

Provider Business Mailing Address
First Line	:	118 WEST ST
Second Line	:	APT 408
City	:	RENO
State	:	NV
Zip	:	89501-1331
Country	:	US
Telephone Number	:	775-682-8686
Fax Number	:	775-784-1126

Provider Business Practice Location Address
First Line	:	118 WEST ST
Second Line	:	APT 408
City	:	RENO
State	:	NV
Zip	:	89501-1331
Country	:	US
Telephone Number	:	775-682-8686
Fax Number	:	775-784-1126

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/29/2019
Last Update Date	:	08/12/2019

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Directions to “ RICHARD BREUNER ” Practice Location

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