Individual
BRENNA KIDWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3016 POLAR LN BLDG 3, CEDAR PARK, TX 78613-3031
(512) 593-5231
Mailing address
2425 HIGH LONESOME, LEANDER, TX 78641-3285
(940) 595-0761
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
01/19/2021
Last updated
01/19/2021
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