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1982462750
EVAN TODD BRACKENBURY
TACOMA, WA
NPI
1982462750
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101Y00000X Counselor
Additional Taxonomies
106S00000X Behavior Technician
Enumeration Date
2024-03-07
Last Update Date
2024-08-19
Business Address
EVAN TODD BRACKENBURY
8811 S TACOMA WAY STE 204&206
TACOMA, WA 98499-4595
Phone number: 425-217-1140
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Mailing Address
EVAN TODD BRACKENBURY
11114 W ARICA RD
CASA GRANDE, AZ 85193-9033
Phone number: 520-634-8601
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