Provider Demographics
NPI:1861880023
Name:MADDEN, BROOK (BCBA)
Entity type:Individual
Prefix:
First Name:BROOK
Middle Name:
Last Name:MADDEN
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:PO BOX 28921
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89126-2921
Mailing Address - Country:US
Mailing Address - Phone:702-350-1875
Mailing Address - Fax:833-901-4030
Practice Address - Street 1:200 HOOVER AVE UNIT 1413
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89101-6880
Practice Address - Country:US
Practice Address - Phone:702-350-1875
Practice Address - Fax:833-901-4030
Is Sole Proprietor?:No
Enumeration Date:2014-12-22
Last Update Date:2022-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst