Provider Demographics
NPI:1184483158
Name:BROOKSHIRE, SKYE MCKENZIE
Entity type:Individual
Prefix:
First Name:SKYE
Middle Name:MCKENZIE
Last Name:BROOKSHIRE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:712 TEE BOX CT
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:SC
Mailing Address - Zip Code:29745-7766
Mailing Address - Country:US
Mailing Address - Phone:803-526-5998
Mailing Address - Fax:
Practice Address - Street 1:712 TEE BOX CT
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:SC
Practice Address - Zip Code:29745-7766
Practice Address - Country:US
Practice Address - Phone:803-526-5998
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-13
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst