Individual
MARDRAKUS COLBERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
331 LANDRUM PL, CLARKSVILLE, TN 37043-6329
(931) 553-1395
Mailing address
331 LANDRUM PL, CLARKSVILLE, TN 37043-6329
(931) 553-1395
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
TN
Other
Enumeration date
05/02/2024
Last updated
05/02/2024
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