| Doctor Name: | MRS. LISA L BROOKS |
| NPI Number: | 1114224334 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PLPC |
| License Number: | 2011003865 |
| Business Practice Address: | 3001 Warrior Ln Poplar Bluff, MO - 639018685 |
| Business Phone Number: | 5736861200 |
| Business Fax Number: | 5737122194 |
| Mailing Address: | 3001 Warrior Ln, POPLAR BLUFF |
| State: | MO |
| Postal Code: | 639018685 |
| Phone Number: | 5736861200 |
| Fax Number: | 5737122194 |
| NPI Enumeration Date: | 02/24/2011 |
| NPI Last Update Date: | 02/24/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 2011003865 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |