Provider Demographics
NPI:1386111441
Name:GIVENS, BREANA NICOLE (MPA, BS)
Entity type:Individual
Prefix:
First Name:BREANA
Middle Name:NICOLE
Last Name:GIVENS
Suffix:
Gender:F
Credentials:MPA, BS
Other - Prefix:
Other - First Name:BREANA
Other - Middle Name:
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MARRIED NAME
Mailing Address - Street 1:3035 S MARYLAND PKWY
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89109-2202
Mailing Address - Country:US
Mailing Address - Phone:702-232-6333
Mailing Address - Fax:
Practice Address - Street 1:3035 S MARYLAND PKWY
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89109-2202
Practice Address - Country:US
Practice Address - Phone:702-232-6333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-26
Last Update Date:2018-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst