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NPI Code Detail

MEDICARE: BREANNE HALEY

MEDICARE: BREANNE HALEY
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 Analyst1-26-89964IL

General Provider Information

NPI Number : 1629909189
Entity Type Code : Individual
Provider Name (Legal Business Name) : BREANNE HALEY
Provider Business Mailing Address
First Line : 820 PARKVIEW BLVD
Second Line :
City : LOMBARD
State : IL
Zip : 60148-3200
Country : US
Telephone Number : 331-256-5255
Fax Number :
Provider Business Practice Location Address
First Line : 820 PARKVIEW BLVD
Second Line :
City : LOMBARD
State : IL
Zip : 60148-3200
Country : US
Telephone Number : 331-256-5255
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/26/2026
Last Update Date : 05/26/2026

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Directions to “ BREANNE HALEY ” Practice Location

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