Provider Demographics
NPI:1790137099
Name:KIRCHNER, BRANDON
Entity Type:Individual
Prefix:MR
First Name:BRANDON
Middle Name:
Last Name:KIRCHNER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 S FORT APACHE RD UNIT 1233
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-5714
Mailing Address - Country:US
Mailing Address - Phone:702-459-7500
Mailing Address - Fax:702-333-4480
Practice Address - Street 1:2200 S FORT APACHE RD UNIT 1233
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-5714
Practice Address - Country:US
Practice Address - Phone:702-459-7500
Practice Address - Fax:702-333-4480
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-11
Last Update Date:2016-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst