| Doctor Name: | BROOKE V DEROUEN |
| NPI Number: | 1023312816 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MA, CAC, PLPC |
| License Number: | PLC6278 |
| Business Practice Address: | 500 Roderick St Suite B Morgan City, LA - 703802247 |
| Business Phone Number: | 9853802460 |
| Business Fax Number: | 9853802476 |
| Mailing Address: | 500 Roderick St, Suite B MORGAN CITY |
| State: | LA |
| Postal Code: | 703802247 |
| Phone Number: | 9853802460 |
| Fax Number: | 9853802476 |
| NPI Enumeration Date: | 01/07/2011 |
| NPI Last Update Date: | 05/06/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | PLC6278 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | LA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |