Individual
MISS BRANDI NICHOLE LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, MPM, QIDP, QMHA
Contact information
Practice address
2580 N RANCHO DR STE 104A, LAS VEGAS, NV 89130-3361
(480) 795-0209
Mailing address
2580 N RANCHO DR STE 104A, LAS VEGAS, NV 89130-3361
(480) 795-0209
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
03/11/2024
Last updated
03/11/2024
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