Brian T Staub I

NPI #1982178836 in Wasilla, Alaska

Provider Information

NPI Number: 1982178836
Entity Type: Individual
Name: Brian T Staub I
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Behavior Technician
Enumeration Date: Jan 14, 2019
Last Updated: Jan 14, 2019

Practice Location

Address: 300 W SWANSON AVE
City: Wasilla
State: Alaska
ZIP Code: 99654-6844
Phone: (907) 521-0890

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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