Individual
MR. GARLAND EDWARD BROTHERTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3625 14TH ST, RIVERSIDE, CA 92501-3815
(951) 358-6680
Mailing address
5059 QUAIL RUN RD APT 160, RIVERSIDE, CA 92507-6487
(951) 966-4501
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
106S00000X
Behavior Technician
—
—
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
12/31/2019
Last updated
04/28/2021
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