Provider Demographics
NPI:1780464263
Name:CHENG, BROOKE ELLEN (BCBA)
Entity type:Individual
Prefix:
First Name:BROOKE
Middle Name:ELLEN
Last Name:CHENG
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:BROOKE
Other - Middle Name:ELLEN
Other - Last Name:BUSSINK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:205 NATOMA CT
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30022-8487
Mailing Address - Country:US
Mailing Address - Phone:770-990-2903
Mailing Address - Fax:
Practice Address - Street 1:7 DUNWOODY PARK STE 116
Practice Address - Street 2:
Practice Address - City:DUNWOODY
Practice Address - State:GA
Practice Address - Zip Code:30338-6711
Practice Address - Country:US
Practice Address - Phone:470-223-8123
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-03
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst