MEDICARE: BROOKE BAILEY HUMPHREY

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
1	103K00000X	Behavior Analyst	BHV-010508	TX

General Provider Information

NPI Number	:	1326974072
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BROOKE BAILEY HUMPHREY

Provider Business Mailing Address
First Line	:	PO BOX 8342
Second Line	:
City	:	HUNTSVILLE
State	:	TX
Zip	:	77340-0006
Country	:	US
Telephone Number	:	337-707-0636
Fax Number	:

Provider Business Practice Location Address
First Line	:	1620 NORMAL PARK DR
Second Line	:
City	:	HUNTSVILLE
State	:	TX
Zip	:	77340-4235
Country	:	US
Telephone Number	:	337-707-0636
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/22/2026
Last Update Date	:	06/22/2026

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Directions to “ BROOKE BAILEY HUMPHREY ” Practice Location

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