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1598542102
BRANDON SUPAK
DULUTH, GA
NPI
1598542102
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2023-09-08
Last Update Date
2023-09-08
Business Address
BRANDON SUPAK
2760 PEACHTREE INDUSTRIAL BLVD STE C
DULUTH, GA 30097-2201
Phone number: 470-502-5637
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Mailing Address
BRANDON SUPAK
2753 HOLLY RIDGE CIR
MARIETTA, GA 30062-4632
Phone number: 845-987-4458
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