Doctor Name: | ELMA KATHERINE MCBROOM |
NPI Number: | 1003107236 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC |
License Number: | 2010033339 |
Business Practice Address: | 485 Schofer St Rolla, MO - 654018040 |
Business Phone Number: | 5732029790 |
Business Fax Number: | |
Mailing Address: | 485 Schofer St, ROLLA |
State: | MO |
Postal Code: | 654018040 |
Phone Number: | 5732029790 |
Fax Number: | |
NPI Enumeration Date: | 04/21/2011 |
NPI Last Update Date: | 07/17/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 2010033339 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |