Provider Demographics
NPI:1023358074
Name:BROOKS, BARBARA H (MA, BCBA)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:H
Last Name:BROOKS
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:353 18TH AVE
Mailing Address - Street 2:
Mailing Address - City:PATERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07504-1336
Mailing Address - Country:US
Mailing Address - Phone:201-532-0684
Mailing Address - Fax:973-345-6263
Practice Address - Street 1:353 18TH AVE
Practice Address - Street 2:
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07504-1336
Practice Address - Country:US
Practice Address - Phone:201-532-0684
Practice Address - Fax:973-345-6263
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-27
Last Update Date:2013-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-08-4665103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst