Individual
BROOKE BREAUX CHAMBERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
B.A., M.A.
Contact information
Practice address
7705 SE 66TH AVE, PORTLAND, OR 97206-9613
(225) 278-4802
Mailing address
7705 SE 66TH AVE, PORTLAND, OR 97206-9613
(225) 278-4802
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
HK001N6W
—
OR
Enumeration date
08/16/2019
Last updated
08/16/2019
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