Individual
DHARA BRAHMBHATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7360 N LINCOLN AVE STE 110, LINCOLNWOOD, IL 60712-1705
(855) 855-2712
Mailing address
225 CEDAR HILL ST STE 200, MARLBOROUGH, MA 01752-5900
(847) 262-1401
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
J20017485704
DRIVER'S LICENSE
IL
Enumeration date
05/07/2020
Last updated
05/07/2020
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