Provider Demographics
NPI:1245926641
Name:DENNY, BROOKE TAYLOR I
Entity type:Individual
Prefix:
First Name:BROOKE
Middle Name:TAYLOR
Last Name:DENNY
Suffix:I
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 1:1652 KELLER PKWY
Mailing Address - Street 2:
Mailing Address - City:KELLER
Mailing Address - State:TX
Mailing Address - Zip Code:76248-3875
Mailing Address - Country:US
Mailing Address - Phone:682-291-9910
Mailing Address - Fax:
Practice Address - Street 1:1652 KELLER PKWY STE 200
Practice Address - Street 2:
Practice Address - City:KELLER
Practice Address - State:TX
Practice Address - Zip Code:76248-3877
Practice Address - Country:US
Practice Address - Phone:682-291-9910
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-18
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
TXRBT-23-265842106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician