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NPI Code Detail

MEDICARE: MRS. BROOKE ELIZABETH BAILEY

MEDICARE: MRS. BROOKE ELIZABETH BAILEY
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
1106S00000XBehavior Technician
2103K00000XBehavior Analyst1-19-35865

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1205379120
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. BROOKE ELIZABETH BAILEY
Provider Business Mailing Address
First Line : 1775 W STATE ROAD 434
Second Line :
City : LONGWOOD
State : FL
Zip : 32750-5067
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1775 W STATE ROAD 434
Second Line :
City : LONGWOOD
State : FL
Zip : 32750-5067
Country : US
Telephone Number : 407-919-6845
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/25/2016
Last Update Date : 01/18/2024

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Directions to “ MRS. BROOKE ELIZABETH BAILEY ” Practice Location

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