| Doctor Name: | DR. DOUGLAS A BROOKS |
| NPI Number: | 1043201221 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PHD |
| License Number: | 00218 |
| Business Practice Address: | 2702 Cunningham Ave Ste A Joplin, MO - 648041570 |
| Business Phone Number: | 4177821910 |
| Business Fax Number: | 4177821844 |
| Mailing Address: | 2702 Cunningham Ave, Ste A JOPLIN |
| State: | MO |
| Postal Code: | 648041570 |
| Phone Number: | 4177821910 |
| Fax Number: | 4177821844 |
| NPI Enumeration Date: | 11/04/2005 |
| NPI Last Update Date: | 04/11/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 00218 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |