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Individual
MRS. KIM BRANTLEY
Active
Individual
MRS. KIM BRANTLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ABA THERAPIST
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
709609
NY
Other
Enumeration date
07/02/2012
Last updated
07/02/2012
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