Individual
BRENDEN MACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
107 RANCH ROAD 620 S, LAKEWAY, TX 78734-3942
(512) 717-4788
(512) 519-8742
Mailing address
107 RANCH ROAD 620 S, LAKEWAY, TX 78734-3942
(512) 717-4788
(512) 519-8742
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
20-110438
TX
Other
Enumeration date
01/24/2020
Last updated
01/24/2020
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