Provider Demographics
NPI:1235625658
Name:GILBERT, BROOKLYNN (BCBA)
Entity Type:Individual
Prefix:
First Name:BROOKLYNN
Middle Name:
Last Name:GILBERT
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:171 STATE HIGHWAY 83 UNIT A101
Mailing Address - Street 2:
Mailing Address - City:DEFUNIAK SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32433-7427
Mailing Address - Country:US
Mailing Address - Phone:850-585-9189
Mailing Address - Fax:850-951-0898
Practice Address - Street 1:40 STATE HIGHWAY 83
Practice Address - Street 2:
Practice Address - City:DEFUNIAK SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32433-7404
Practice Address - Country:US
Practice Address - Phone:850-585-9189
Practice Address - Fax:850-951-0898
Is Sole Proprietor?:No
Enumeration Date:2018-07-09
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst