Individual
BROOKE JUNIOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
55 MAIN STREET, SUITE 6, GOSHEN, NY 10924
(845) 360-5744
Mailing address
PO BOX 622, UNIONVILLE, NY 10988
(845) 820-3944
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
06/11/2019
Last updated
06/11/2019
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