Individual
BROOKE KRIDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5601 COVENTRY LN, FORT WAYNE, IN 46804-7145
(260) 459-6040
Mailing address
5601 COVENTRY LN, FORT WAYNE, IN 46804-7145
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
RBT-20-145251
IN
Other
Enumeration date
02/09/2024
Last updated
02/09/2024
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