Mariah Lynnette Brisco
NPI #1992280515 in Fairfield, California
Provider Information
- NPI Number
- 1992280515
- Entity Type
- Individual
- Name
- Mariah Lynnette Brisco
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Behavior Technician
- Enumeration Date
- Sep 28, 2018
- Last Updated
- Nov 7, 2018
Practice Location
- Address
- 744 EMPIRE ST # 160
- City
- Fairfield
- State
- California
- ZIP Code
- 94533-5562
- Phone
- (707) 399-9413
Specialties & Taxonomy Codes
| Specialty |
|---|
| Behavior Technician |
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