Individual
MR. BRIAN LEE STAGG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ED.S.
Contact information
Practice address
4126 S DEMAREE ST STE B, VISALIA, CA 93277-9514
(559) 943-7076
Mailing address
4126 S DEMAREE ST STE B, VISALIA, CA 93277-9514
(559) 943-7076
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
1-11-8934
CA
103TS0200X
School Psychologist
Primary
3487
CA
Other
Enumeration date
06/18/2014
Last updated
05/07/2015
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