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NPI Code Detail

MEDICARE: MRS. AMBERLY BROOK CABALLERO MSED, BCBA, BSL, IEC

MEDICARE: MRS. AMBERLY BROOK CABALLERO MSED, BCBA, BSL, IEC
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
1103K00000XBehavior AnalystPA

General Provider Information

NPI Number : 1891073433
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. AMBERLY BROOK CABALLERO MSED, BCBA, BSL, IEC
Provider Business Mailing Address
First Line : 100 CREST CT
Second Line :
City : WEDDINGTON
State : NC
Zip : 28104-5626
Country : US
Telephone Number : 267-978-4305
Fax Number :
Provider Business Practice Location Address
First Line : 110 CHURCH ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19106-2201
Country : US
Telephone Number : 267-807-0550
Fax Number : 704-389-3193
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/01/2011
Last Update Date : 06/06/2025

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