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1376010173
BRANDON WATERBURY
RICHMOND, IN
NPI
1376010173
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: IN 39002851A)
Enumeration Date
2018-10-30
Last Update Date
2018-10-30
Business Address
BRANDON WATERBURY
498 NW 18TH ST BLDG 416
RICHMOND, IN 47374-2851
Phone number: 765-914-3937
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Mailing Address
BRANDON WATERBURY
7471 GEIST VALLEY BLVD
INDIANAPOLIS, IN 46236-8596
Phone number:
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