Doctor Name: | DAVID RANDALL BROOKS |
NPI Number: | 1750559118 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | BSW |
License Number: | |
Business Practice Address: | 129 N 3rd Ave Ste E Purcell, OK - 730804244 |
Business Phone Number: | 4055279562 |
Business Fax Number: | 4053604918 |
Mailing Address: | 129 N 3rd Ave Ste E, PURCELL |
State: | OK |
Postal Code: | 730804244 |
Phone Number: | 4055279562 |
Fax Number: | 4053604918 |
NPI Enumeration Date: | 02/19/2008 |
NPI Last Update Date: | 02/19/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |