Provider Demographics
NPI:1235742958
Name:DELOERA, BROOKE RAYE (RBT)
Entity Type:Individual
Prefix:
First Name:BROOKE
Middle Name:RAYE
Last Name:DELOERA
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:BROOKE
Other - Middle Name:RAYE
Other - Last Name:HUFFMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1212 S AIR DEPOT BLVD STE 9
Mailing Address - Street 2:
Mailing Address - City:MIDWEST CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73110-4860
Mailing Address - Country:US
Mailing Address - Phone:405-455-6868
Mailing Address - Fax:405-562-3444
Practice Address - Street 1:1212 S AIR DEPOT BLVD STE 9
Practice Address - Street 2:
Practice Address - City:MIDWEST CITY
Practice Address - State:OK
Practice Address - Zip Code:73110-4860
Practice Address - Country:US
Practice Address - Phone:405-455-6868
Practice Address - Fax:405-562-3444
Is Sole Proprietor?:No
Enumeration Date:2020-08-24
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
OKRBT-23-26287106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No171M00000XOther Service ProvidersCase Manager/Care Coordinator