Individual
BROOKE FREDERICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
600 N 93RD ST STE 200, OMAHA, NE 68114-2616
(402) 230-5861
(531) 200-5808
Mailing address
13322 I ST, OMAHA, NE 68137-1111
(402) 230-5861
(531) 200-5808
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-18-32292
NE
103K00000X
Behavior Analyst
BCBA-1-18-32292
NE
Other
Enumeration date
07/17/2018
Last updated
11/01/2022
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