| Doctor Name: | MICHELE MYRUS BROOKS |
| NPI Number: | 1538357355 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 1102846 |
| Business Practice Address: | 12279 W Grier Rd Marana, AZ - 856539606 |
| Business Phone Number: | 5206824782 |
| Business Fax Number: | |
| Mailing Address: | 4156 E Calle Marfil, TUCSON |
| State: | AZ |
| Postal Code: | 857126409 |
| Phone Number: | 5206824782 |
| Fax Number: | |
| NPI Enumeration Date: | 10/05/2007 |
| NPI Last Update Date: | 10/05/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TS0200X |
| License Number: | 1102846 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AZ |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | School |
| Taxonomy Definition: | |