MS. Autumn Breshawn Pannkuk

NPI #1144840422 in Edgewater, Maryland

Provider Information

NPI Number: 1144840422
Entity Type: Individual
Name: MS. Autumn Breshawn Pannkuk
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: Apr 16, 2020
Last Updated: Apr 16, 2020

Practice Location

Address: 1395 BAYSIDE DR
City: Edgewater
State: Maryland
ZIP Code: 21037-4421
Phone: (951) 283-8174

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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