Individual
BROOKE TAWANNA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
17848 SKY PARK CIR STE B, IRVINE, CA 92614-6135
(949) 418-7167
Mailing address
17848 SKY PARK CIR STE B, IRVINE, CA 92614-6135
(949) 418-7167
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
11211493
CA
103K00000X
Behavior Analyst
Primary
BCBA 1-12-11493
CA
Other
Enumeration date
11/19/2012
Last updated
08/10/2021
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