Provider Demographics
NPI:1982212197
Name:HENSMANN, BROOKE MICHELLE
Entity type:Individual
Prefix:
First Name:BROOKE
Middle Name:MICHELLE
Last Name:HENSMANN
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:PO BOX 258831
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73125-8831
Mailing Address - Country:US
Mailing Address - Phone:720-961-3764
Mailing Address - Fax:
Practice Address - Street 1:88 INVERNESS CIR E UNIT H103
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80112-5503
Practice Address - Country:US
Practice Address - Phone:702-961-3764
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-14
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO12472695103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst