Eric Dustin Brisbon

NPI #1902422090 in Lake Mary, Florida

Provider Information

NPI Number: 1902422090
Entity Type: Individual
Name: Eric Dustin Brisbon
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Behavior Technician
Enumeration Date: Jun 24, 2020
Last Updated: Jun 24, 2020

Practice Location

Address: 200 WAYMONT CT STE 122
City: Lake Mary
State: Florida
ZIP Code: 32746-3413
Phone: (407) 710-8566

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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