Individual
ANNESSA LEEANN BROCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
1055 E COLORADO BLVD STE 560, PASADENA, CA 91106-2380
(818) 241-6780
(818) 241-6853
Mailing address
1055 E COLORADO BLVD STE 560, PASADENA, CA 91106-2380
(818) 241-6780
(818) 241-6853
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
52270
CA
Other
Enumeration date
05/02/2019
Last updated
08/30/2021
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