Healthcare Provider Details
I. General information
NPI: 1730798455
Provider Name (Legal Business Name): THE BROOK CENTER: THERAPY SOLUTIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/28/2020
Last Update Date: 07/28/2020
Certification Date: 07/28/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2286 JONES CREEK RD
WHITE BLUFF TN
37187-4213
US
IV. Provider business mailing address
PO BOX 1832
DICKSON TN
37056-1832
US
V. Phone/Fax
- Phone: 615-319-8021
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ASHLEY
BROOK
RUF
Title or Position: BCBA/OWNER
Credential: MA
Phone: 615-319-8021