Individual
BRIELLE MARIE HUMBIRD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2104 GREENBRIAR DR, SOUTHLAKE, TX 76092-8355
(817) 442-9022
Mailing address
976 MOORE PL, ODESSA, MO 64076-3500
(630) 486-8397
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
02/14/2023
Last updated
02/14/2023
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