Provider Demographics
NPI:1689388530
Name:BRADSHAW-SPRINGER, BROOKLYNNE NICHOLE (BCBA)
Entity Type:Individual
Prefix:
First Name:BROOKLYNNE
Middle Name:NICHOLE
Last Name:BRADSHAW-SPRINGER
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 1:3200 W COLFAX AVE APT 225
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80204-2258
Mailing Address - Country:US
Mailing Address - Phone:217-883-0845
Mailing Address - Fax:
Practice Address - Street 1:550 THORNTON PKWY UNIT 234
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80229-2167
Practice Address - Country:US
Practice Address - Phone:720-459-7493
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-05
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1-21-55786103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst