Individual
AKIAH BRUNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4196 DOUGLAS BLVD, GRANITE BAY, CA 95746-5904
(916) 489-1376
(916) 489-1386
Mailing address
PO BOX 5157, MODESTO, CA 95352-5157
(209) 572-2589
(209) 572-1461
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
18-72265
CA
Other
Enumeration date
11/07/2018
Last updated
01/16/2019
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