Most Relevant Information
Provider Data
| NPI Number: | 1003587122 |
| Provider Name: | BROOKE HENDERSON |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 09/28/2021 |
| Last Updated: | 04/20/2023 |
Provider Practice Location
1024 W DAKIN ST APT 1W
CHICAGO
IL
606132991
Practice Location Phone/Fax
| Phone: | 9167656942 |
| Fax: |
Provider Mailing Location
1024 W DAKIN ST APT 1W
CHICAGO
IL
606132991
Provider Mailing Phone/Fax
| Phone: | 9167656942 |
| Fax: |