Individual
MRS. BROOKE ELIZABETH EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
2505 E JEFFERSON BLVD, SOUTH BEND, IN 46615-2635
(574) 289-4831
Mailing address
2505 E JEFFERSON BLVD, SOUTH BEND, IN 46615-2635
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-22-58891
IN
103K00000X
Behavior Analyst
—
—
106S00000X
Behavior Technician
RBT-18-51076
IN
Other
Enumeration date
08/26/2020
Last updated
11/01/2023
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