Individual
BRANDON JOHN DOUGLAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
718 S ELIZABETH ST, WICHITA, KS 67213-3842
(316) 833-8093
Mailing address
718 S ELIZABETH ST, WICHITA, KS 67213-3842
(316) 833-8093
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
10/03/2022
Last updated
10/03/2022
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