Individual
BROOKE JACQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
1166 S GILBERT RD, GILBERT, AZ 85296-3460
(602) 535-8341
Mailing address
700 N DOBSON RD UNIT 48, CHANDLER, AZ 85224-6974
(480) 773-9786
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-22-61960
AZ
Other
Enumeration date
08/30/2018
Last updated
06/20/2023
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