Individual
JACKIE TRIMBLE BREWER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RBT
Contact information
Practice address
10 6TH AVE W, HUNTINGTON, WV 25701-0028
(304) 825-8014
Mailing address
4848 SAMMONS RD, ASHLAND, KY 41101-6916
(606) 205-3261
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-18-67317
WV
Other
Enumeration date
12/16/2018
Last updated
12/16/2018
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