Most Relevant Information
Provider Data
| NPI Number: | 1003647926 |
| Provider Name: | BRENDA BLITTERSDORF |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 08/12/2024 |
| Last Updated: | 08/12/2024 |
Provider Practice Location
8025 N POINT BLVD STE 100
WINSTON SALEM
NC
271063291
Practice Location Phone/Fax
| Phone: | 7047804271 |
| Fax: |
Provider Mailing Location
8025 N POINT BLVD STE 100
WINSTON SALEM
NC
271063291
Provider Mailing Phone/Fax
| Phone: | 7047804271 |
| Fax: |