Individual
BROOKE WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
13015 W 2ND PL APT 212, LAKEWOOD, CO 80228-1317
(720) 272-1289
Mailing address
13015 W 2ND PL APT 212, LAKEWOOD, CO 80228-1317
(720) 272-1289
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
07/17/2015
Last updated
07/17/2015
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