Lucky, Breanna

Lucky, Breanna is an individual health care provider with primary practice located at 6455 S Shore Blvd Ste 400 , League City TX 77573-5525. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Behavior Technician, Behavioral Health & Social Service Providers / Behavioral Analyst. Behavioral Health & Social Service Providers / Behavioral Analyst is her primary health care specialty. Lucky, Breanna can be contacted via phone (855) 782-7822.

Contact Information

Primary practice address
6455 S Shore Blvd Ste 400 League City TX 77573-5525
Phone: (855) 782-7822
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Behavior Technician 106S00000X 18-04855 Texas
Behavioral Health & Social Service Providers / Behavioral Analyst 103K00000X 5608 Texas

Profile Details

NPI number 1326531625
LBN Legal business name Lucky, Breanna
Credentials BCBA
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 11th, 2018
Last updated Feb 1st, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1326531625 NPPES
Texas MEDICAID 18-04855

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