Individual
BRANDY GAIL EMDIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2007 ELIZABETH BLVD, TWIN FALLS, ID 83301-7038
(208) 320-6343
Mailing address
2007 ELIZABETH BLVD, TWIN FALLS, ID 83301-7038
(208) 320-6343
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
106SOOOOOX
—
ID
Enumeration date
05/12/2020
Last updated
05/13/2020
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