Ethan Brock
Ethan Brock is a Behavior Technician in Alexandria, Virginia. Registered with an NPI since 2022.
- In the registry since
- 2022
Practice location Address checks out
6400 Grovedale DrAlexandria, VA 22310-2504
Phone: (571) 290-0143
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Specialties & licences
| Behavior Technician (primary) | Taxonomy 106S00000X |
|---|
Record details
| NPI number | 1598491474 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | No |
| NPI enumerated | July 25, 2022 |
| Last updated in NPPES | July 25, 2022 |
| Certification date | July 25, 2022 |
| Mailing address | 5850 Granite Pkwy Ste 600, Plano, TX 75024-6753 |
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