Individual
GABRIELLE BROCKERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4664 LARWELL DR, COLUMBUS, OH 43220-3621
(614) 487-7809
Mailing address
5139 PHEASANT ST, LIMA, OH 45807-1450
(419) 231-0996
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
08/03/2020
Last updated
08/03/2020
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