Individual
BROOKLYN MAKENZIE MADDOX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
201 REGENCY PKWY, MANSFIELD, TX 76063-5090
(682) 400-0305
Mailing address
9120 PERIDOT WAY, FORT WORTH, TX 76123-5116
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BACB1604838
TX
106S00000X
Behavior Technician
Primary
BACB1604838
TX
Other
Enumeration date
06/01/2026
Last updated
06/11/2026
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