Jaci Carolynn Brantley

NPI #1750083739 in Belvidere, Illinois

Provider Information

NPI Number: 1750083739
Entity Type: Individual
Name: Jaci Carolynn Brantley
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Developmental Therapist
Enumeration Date: Mar 21, 2023
Last Updated: Mar 21, 2023

Practice Location

Address: 622 RUTH CIR
City: Belvidere
State: Illinois
ZIP Code: 61008-5548
Phone: (414) 940-5581

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Developmental Therapist	222Q00000X	Primary

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