Provider Demographics
NPI:1174050793
Name:CURTIS, NADARA BREUNTA
Entity type:Individual
Prefix:
First Name:NADARA
Middle Name:BREUNTA
Last Name:CURTIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2411 S I 35 E APT 1725
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76210-4965
Mailing Address - Country:US
Mailing Address - Phone:940-300-9349
Mailing Address - Fax:
Practice Address - Street 1:190 CIVIC CIR STE 250
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75067-3648
Practice Address - Country:US
Practice Address - Phone:972-219-1200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-13
Last Update Date:2017-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician