Individual
BROOKA LOUISE BYFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
1301 RUSSELL RD, RUSSELLVILLE, AR 72802-4320
(479) 967-2322
(479) 967-2876
Mailing address
PO BOX 2109, RUSSELLVILLE, AR 72811-2109
(479) 967-2322
(479) 967-2876
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-21-181640
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
273705706
—
AR
Enumeration date
02/24/2022
Last updated
01/05/2023
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