Individual
HALEY MARIE BROCIOUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
3341 S OATES ST, DOTHAN, AL 36301-5889
(251) 214-1722
Mailing address
3341 S OATES ST, DOTHAN, AL 36301-5889
(251) 214-1722
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
BACB736706
FL
Other
Enumeration date
12/20/2021
Last updated
12/20/2021
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