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Individual

BRIAN A WHITE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
6N202 BOXWOOD LN, ST CHARLES, IL 60175-8327
(630) 399-4672
Mailing address
6N202 BOXWOOD LN, ST CHARLES, IL 60175-8327

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Enumeration date
10/24/2018
Last updated
10/24/2018
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