Individual
BRENNON DANTZLER-CAMPBELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RBT
Contact information
Practice address
3766 US HIGHWAY 17 STE 301, RICHMOND HILL, GA 31324-8876
(904) 538-0713
(904) 538-0714
Mailing address
10175 FORTUNE PKWY UNIT 903, JACKSONVILLE, FL 32256-6755
(904) 538-0713
(904) 538-0714
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-23-254833
GA
Other
Enumeration date
01/23/2023
Last updated
01/23/2023
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