Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst |
NPI | 1013328590 |
---|---|
Provider Name | Aubrey Lynn Brooks |
First Address | Eudora, KS 66025-9417 |
Second Address | Eudora, KS 66025-9417 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2014 |
Last Update Date | 18/05/2014 |