Individual
BRIAN KEITH MCCORMICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
38 N SCOTT ST, CARBONDALE, PA 18407-1888
(570) 281-6340
Mailing address
1821 FARR ST, SCRANTON, PA 18504-1131
(570) 299-1450
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BH001657
PA
Other
Enumeration date
02/12/2020
Last updated
02/12/2020
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