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NPI Code Detail

MEDICARE: LINDSEY BROCKIE

MEDICARE: LINDSEY BROCKIE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1247200000XOther Technician
2103K00000XBehavior Analyst1-20-41379OK

General Provider Information

NPI Number : 1003167503
Entity Type Code : Individual
Provider Name (Legal Business Name) : LINDSEY BROCKIE
Provider Business Mailing Address
First Line : 14828 SERENITA AVE
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73134
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 16538 N MAY AVE
Second Line :
City : EDMOND
State : OK
Zip : 73012-9007
Country : US
Telephone Number : 405-253-0071
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/24/2012
Last Update Date : 08/18/2021

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Directions to “ LINDSEY BROCKIE ” Practice Location

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