Individual
BRENDAN BROCK ERWIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1902 RIDGE RD, LEAVENWORTH, KS 66048-6507
(707) 398-5677
Mailing address
6214 24TH AVE, BROOKLYN, NY 11204-3319
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
06/02/2023
Last updated
06/02/2023
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