Most Relevant Information
Provider Data
| NPI Number: | 1003582636 |
| Provider Name: | BRENA LONDON |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 08/23/2021 |
| Last Updated: | 08/23/2021 |
Provider Practice Location
8542 W GRAND RIVER AVE
BRIGHTON
MI
481162326
Practice Location Phone/Fax
| Phone: | 7344494649 |
| Fax: |
Provider Mailing Location
8542 W GRAND RIVER AVE
BRIGHTON
MI
481162326
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |