Individual
BRANDON IRVIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
115 PRIVATE ROAD 977, PEDRO, OH 45659-8608
(740) 534-1386
Mailing address
115 PRIVATE ROAD 977, PEDRO, OH 45659-8608
(740) 534-1386
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
09/20/2018
Last updated
09/28/2018
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