Evan Todd Brackenbury
Evan Todd Brackenbury is a Counselor in Tacoma, Washington. Registered with an NPI since 2024.
- In the registry since
- 2024
- Specialties on file
- 2
Practice location Address checks out
8811 S Tacoma Way Ste 204&206Tacoma, WA 98499-4595
Phone: (425) 217-1140
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Specialties & licences
| Counselor (primary) | Taxonomy 101Y00000X |
|---|---|
| Behavior Technician | Taxonomy 106S00000X |
Record details
| NPI number | 1982462750 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | No |
| NPI enumerated | March 7, 2024 |
| Last updated in NPPES | August 19, 2024 |
| Certification date | August 19, 2024 |
| Mailing address | 11114 W Arica Rd, Casa Grande, AZ 85193-9033 |
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