Doctor Name: | BROOKE MARTIN |
NPI Number: | 1073780862 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 81880 Dr Carreon Blvd Suite C-208 Indio, CA - 922015559 |
Business Phone Number: | 7609894900 |
Business Fax Number: | |
Mailing Address: | 81880 Dr Carreon Blvd, Suite C-208 INDIO |
State: | CA |
Postal Code: | 922015559 |
Phone Number: | 7609894900 |
Fax Number: | |
NPI Enumeration Date: | 05/12/2008 |
NPI Last Update Date: | 05/12/2008 |
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: |