Provider Demographics
NPI:1710683271
Name:KING, BROOKLYNN ASHLEIGH (BCBA)
Entity Type:Individual
Prefix:
First Name:BROOKLYNN
Middle Name:ASHLEIGH
Last Name:KING
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:BROOKLYN
Other - Middle Name:ASHLEIGH
Other - Last Name:KING
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:BCBA
Mailing Address - Street 1:9940 HIGHWAY 92
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:GA
Mailing Address - Zip Code:30188-6417
Mailing Address - Country:US
Mailing Address - Phone:470-473-5920
Mailing Address - Fax:888-979-8504
Practice Address - Street 1:705 CURTIS PKWY SE
Practice Address - Street 2:
Practice Address - City:CALHOUN
Practice Address - State:GA
Practice Address - Zip Code:30701-3677
Practice Address - Country:US
Practice Address - Phone:470-473-5920
Practice Address - Fax:888-979-8504
Is Sole Proprietor?:No
Enumeration Date:2023-02-06
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst