Individual
BRANDON MACIAS HERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3035 S JONES BLVD STE 1, LAS VEGAS, NV 89146-6766
(702) 957-6436
Mailing address
3035 S JONES BLVD STE 1, LAS VEGAS, NV 89146-6766
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-22-204931
NV
Other
Enumeration date
05/12/2022
Last updated
05/12/2022
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