Individual
ELIZABETH BROCKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1222 PHOENIX DR, WAUKESHA, WI 53186-3722
(262) 853-4370
Mailing address
1222 PHOENIX DR, WAUKESHA, WI 53186-3722
(262) 853-4370
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
511-140
WI
Other
Enumeration date
02/16/2022
Last updated
11/27/2024
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