Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
FREDRICCA JAZZMAN BROCK, BCBA
Active Sole ProprietorBehavior Analyst · OLIVE BRANCH, MS
Registration Details
- NPI Number
- 1881207785
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Aug 28, 2020 (5.6483231936457 yrs)
- Last Updated
- Aug 28, 2020
- License
-
12044081 (TN)
- Sole Proprietor
- Yes
Practice Information
- Address
-
8481 REGAL BEND DROLIVE BRANCH, MS, 386544416Browse MS providers · Browse ZIP 38654
- Phone
- 9016065038
- Primary Specialty
-
Behavior Analyst
103K00000X
Other Behavior Analyst Providers in OLIVE BRANCH, MS
| Name | Credential | NPI |
|---|---|---|
| MS. TIFFANY BONDS CAVER | M.S., BCBA | 1578975496 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.