| Doctor Name: | MR. BRETT BROCKETT |
| NPI Number: | 1053461442 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | L..P.C |
| License Number: | 1175 |
| Business Practice Address: | 101 Medical Dr Dothan, AL - 363036903 |
| Business Phone Number: | 3347027222 |
| Business Fax Number: | 3347021944 |
| Mailing Address: | 101 Medical Dr, DOTHAN |
| State: | AL |
| Postal Code: | 363036903 |
| Phone Number: | 3347027222 |
| Fax Number: | 3347021944 |
| NPI Enumeration Date: | 01/10/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 1175 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |