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General NPI Number Information
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NPI Number | 1831972454
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Entity Type | Individual
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Provider Name | BROOKE SMITH RBT
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Gender | Female
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Dates
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Enumeration Date | 08/16/2023
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Last Update Date | 07/01/2025
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Provider Practice Location Address
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Address Line | 1300 N PALAFOX ST STE 103
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City | PENSACOLA
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State | FL
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Zip | 32501-2678
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Country | US
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Telephone | 850-860-2903
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Fax |
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Provider Business Mailing Address
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Address Line | 615 FAIRPOINT DR
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City | GULF BREEZE
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State | FL
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Zip | 32561-4111
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Country | US
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Telephone | 850-463-8810
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 222Q00000X
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Taxonomy Name | Developmental Therapist
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License Number |
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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