Individual
JENNIFER BROSSMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT-23-253709
Contact information
Practice address
1222 W WESTCHESTER WAY, MUSTANG, OK 73064-2303
(405) 816-1014
(405) 422-8249
Mailing address
520 POINTE PARKWAY BLVD, YUKON, OK 73099-0600
(405) 805-6403
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
106S00000X
Behavior Technician
Primary
RBT-23-253709
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
RBT-23-253709
—
OK
Enumeration date
10/11/2011
Last updated
01/23/2023
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