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Individual

GRACE KATHERINE BROTHERTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
BCBA

Contact information

Practice address
12100 N DYSART RD, EL MIRAGE, AZ 85335
(480) 660-8809
Mailing address
12100 N DYSART RD, EL MIRAGE, AZ 85335

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
106S00000X
Behavior Technician
RBT-20-134387
AZ

Other

Enumeration date
10/01/2020
Last updated
09/20/2024
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