Brandi Clark
Behavior Technician in Saint Marys, GA. Individual provider (NPI-1).
NPI number1124516182
StatusActive
Last updated in NPPESApr 25, 2018
Details
- NPI
- 1124516182
- Entity type
- Individual (NPI-1)
- Name
- Brandi Clark
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Apr 25, 2018
- Last updated
- Apr 25, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | RBT-18-54167 | GA | Yes |
Practice location
107 Industrial Dr Ste ESaint Marys, GA 31558-4436
Phone 912-324-5012
Mailing address
10175 Fortune Pkwy Unit 903Jacksonville, FL 32256-6755
Phone 904-538-0713
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All 102 Behavior Technician providers in Saint Marys · All 486 providers in Saint Marys
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