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Individual

DAVAUGHN BROCKETT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
BCBA

Contact information

Practice address
554 BLOOMFIELD AVE FL 4, BLOOMFIELD, NJ 07003-3307
(973) 771-3300
(973) 679-2784
Mailing address
530 S MAIN ST # 1, PHILLIPSBURG, NJ 08865-3116
(973) 908-4953

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-21-50228
NJ

Other

Enumeration date
04/05/2022
Last updated
04/05/2022
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