BRENTT BLACKMON

ELK GROVE, CA
NPI1750951109
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101Y00000X Counselor
Additional Taxonomies106S00000X Behavior Technician
Enumeration Date2021-06-29
Last Update Date2021-09-15
Business Address
BRENTT BLACKMON
9412 BIG HORN BLVD STE 6
ELK GROVE, CA 95758-1101
Phone number: 916-402-9007
Mailing Address
BRENTT BLACKMON
9412 BIG HORN BLVD STE 6
ELK GROVE, CA 95758-1101
Phone number: 916-402-9007