Individual
BRENNA RAVENSHEAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1015 S BROADWAY STE 15, MINOT, ND 58701-4667
(701) 852-6154
Mailing address
1015 S BROADWAY STE 15, MINOT, ND 58701-4667
(701) 852-6154
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
09/19/2023
Last updated
09/19/2023
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