Individual
BRANDY STALLWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2221 LIVERNOIS RD, SUITE 101, TROY, MI 48083-1603
(248) 544-0360
Mailing address
2221 LIVERNOIS RD, SUITE 101, TROY, MI 48083-1603
(248) 544-0360
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
RBT-15-01931
MI
Other
Enumeration date
08/17/2015
Last updated
08/17/2015
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