Doctor Name: | KATHRYN BROOKS |
NPI Number: | 1013198191 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 2303 Gordon Ave Yazoo City, MS - 391942067 |
Business Phone Number: | 6627465712 |
Business Fax Number: | 6627465723 |
Mailing Address: | 2303 Gordon Ave, YAZOO CITY |
State: | MS |
Postal Code: | 391942067 |
Phone Number: | 6627465712 |
Fax Number: | 6627465723 |
NPI Enumeration Date: | 11/17/2007 |
NPI Last Update Date: | 11/17/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |