Individual
LOGAN AMANDA BRINK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5245 SANTA ROSA AVE, SPARKS, NV 89436-3654
(775) 393-9249
Mailing address
5245 SANTA ROSA AVE, SPARKS, NV 89436-3654
(775) 393-9249
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
82-0766847
—
NV
Enumeration date
07/17/2017
Last updated
07/21/2022
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