Individual
TAMMY JO BRANDT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
80 SILVA RD, TOME, NM 87060-0033
(505) 573-0731
Mailing address
PO BOX 33, TOME, NM 87060-0033
(505) 573-0731
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
06/17/2021
Last updated
06/17/2021
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