Individual
MR. BRANDON BENJAMIN VELAZQUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
621 14TH ST, MODESTO, CA 95354-2530
(209) 238-9436
(209) 569-0676
Mailing address
621 14TH ST, MODESTO, CA 95354-2530
(209) 238-9436
(209) 569-0676
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
11/07/2007
Last updated
11/07/2007
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