Most Relevant Information
Provider Data
| NPI Number: | 1003373853 |
| Provider Name: | TARA BRACHTENBACH |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 02/28/2019 |
| Last Updated: | 02/28/2019 |
Provider Practice Location
1936 SUMMIT ST
KANSAS CITY
MO
641082110
Practice Location Phone/Fax
| Phone: | 8168665662 |
| Fax: |
Provider Mailing Location
7139 OULOOK ST
OVERLAND PARK
KS
66204
Provider Mailing Phone/Fax
| Phone: | 7852160014 |
| Fax: |