Individual
BLAZE CARRENO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
X
Contact information
Practice address
971 E WICHITA AVE, RUSSELL, KS 67665-2444
(785) 377-4744
Mailing address
1649 61ST ST, BROOKLYN, NY 11204-2110
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
—
—
Other
Enumeration date
06/04/2025
Last updated
06/04/2025
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