Mya Lemae Brusdahl

NPI #1033928379 in Mishawaka, Indiana

Provider Information

NPI Number: 1033928379
Entity Type: Individual
Name: Mya Lemae Brusdahl
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: Jan 2, 2025
Last Updated: Jan 2, 2025

Practice Location

Address: 1316 W DRAGOON TRL
City: Mishawaka
State: Indiana
ZIP Code: 46544-4713
Phone: (574) 855-4292

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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