Most Relevant Information
Provider Data
| NPI Number: | 1003558099 |
| Provider Name: | BRIAN GERRIT BODT |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 04/10/2022 |
| Last Updated: | 04/10/2022 |
Provider Practice Location
7226 SEPULVEDA BLVD
VAN NUYS
CA
914052003
Practice Location Phone/Fax
| Phone: | 8182351414 |
| Fax: |
Provider Mailing Location
7226 SEPULVEDA BLVD
VAN NUYS
CA
914052003
Provider Mailing Phone/Fax
| Phone: | 8182351414 |
| Fax: |