Individual
MISS BRAINCA SHANTA CHESTNUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
120 E LUZON DR, FORT LIBERTY, NC 28307-6012
(229) 726-8738
Mailing address
500 FAIRWAY DR FL FAIRWAY, DEERFIELD BEACH, FL 33441-1814
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
01/30/2025
Last updated
01/30/2025
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