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Individual
MR. WYATT THOMAS BROOKS
Active
Individual
MR. WYATT THOMAS BROOKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MHP, RBT
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-20-135436
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RBT-20-135436
BEHAVIOR ANALYST CERTIFICATION BOARD
MN
Enumeration date
09/08/2021
Last updated
09/08/2021
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