Renee Lynn Brake

NPI #1104584457 in Nixa, Missouri

Provider Information

NPI Number: 1104584457
Entity Type: Individual
Name: Renee Lynn Brake
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: Dec 3, 2021
Last Updated: Dec 3, 2021

Practice Location

Address: 116 W SHERMAN WAY STE 1
City: Nixa
State: Missouri
ZIP Code: 65714-9022
Phone: (417) 298-0984

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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