Individual
BRANDON CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6919 HILLSDALE CT, INDIANAPOLIS, IN 46250-2054
(844) 263-1613
Mailing address
5410 EMERSON WAY, INDIANAPOLIS, IN 46226
(317) 489-7450
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
04/09/2024
Last updated
02/05/2025
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