Individual
BRIAN BOURKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
70 DORAY DR, PLEASANT HILL, CA 94523-2981
(510) 703-0402
Mailing address
153 SKYWAY DR, VALLEJO, CA 94591-4026
(510) 703-0402
Taxonomy
Speciality
Code
Description
License number
State
101200000X
Drama Therapist
Primary
—
—
Other
Enumeration date
01/15/2022
Last updated
01/15/2022
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