Doctor Name: | NICOLA BROOKS |
NPI Number: | 1073708137 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | PC007127 |
Business Practice Address: | 225 S 69th St Upper Darby, PA - 190824212 |
Business Phone Number: | 6103528943 |
Business Fax Number: | |
Mailing Address: | 225 S 69th St, UPPER DARBY |
State: | PA |
Postal Code: | 190824212 |
Phone Number: | 6103528943 |
Fax Number: | |
NPI Enumeration Date: | 09/12/2007 |
NPI Last Update Date: | 07/17/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | PC007127 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |