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Individual

BETHANY LYNN BROEKEMA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
911 HACIENDA DR STE B, VISTA, CA 92081-6503
(760) 216-6942
Mailing address
911 HACIENDA DR, VISTA, CA 92081-6407
(760) 216-6942

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
235Z00000X
Speech-Language Pathologist
Primary
CA

Other

Enumeration date
12/13/2017
Last updated
01/11/2022
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