Individual
MR. BRANDON PRENDIVILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MC, LAC
Contact information
Practice address
2060 W WHISPERING WIND DR STE 270, PHOENIX, AZ 85085-2869
(480) 653-8434
Mailing address
2060 W WHISPERING WIND DR STE 270, PHOENIX, AZ 85085-2869
(480) 653-8434
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LAC-23086
AZ
Other
Enumeration date
12/20/2024
Last updated
12/20/2024
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