Individual
BRIAN MANBURG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2762 N LINCOLN AVE, CHICAGO, IL 60614-2425
(844) 247-7222
(215) 489-8766
Mailing address
PO BOX 639561, CINCINNATI, OH 45263-9561
(844) 247-7222
(215) 489-8766
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-21-49959
IL
Other
Enumeration date
05/01/2009
Last updated
08/12/2021
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