Individual
BRANDI DAWN CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
710 NW 30TH AVE, SAINT JOHN, KS 67576-8690
(316) 730-1222
Mailing address
710 NW 30TH AVE, SAINT JOHN, KS 67576-8690
(316) 730-1222
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
KS
Other
Enumeration date
09/13/2023
Last updated
09/13/2023
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