Individual
JALAN T BRIMHALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
20860 N TATUM BLVD, PHOENIX, AZ 85050-4274
(866) 342-8847
Mailing address
128 N WILBUR, MESA, AZ 85201-6736
(928) 457-7481
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-19-75773
AZ
Other
Enumeration date
01/16/2019
Last updated
01/16/2019
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