Individual
BROOKE BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
175 STONEBRIDGE LN STE 140, SOUTHLAKE, TX 76092-0318
(855) 782-7822
Mailing address
5522 LONE STAR PKWY STE 101, SAN ANTONIO, TX 78253
(210) 670-8028
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
07/09/2025
Last updated
07/09/2025
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