Individual
KYSHIA BROOKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCAS/OWNER
Contact information
Practice address
4500 HUGH HOWELL RD STE 430, TUCKER, GA 30084-4722
(470) 668-9295
Mailing address
4500 HUGH HOWELL RD STE 430, TUCKER, GA 30084-4722
(470) 668-9295
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2499-A
NC
101YM0800X
Mental Health Counselor
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6008513
—
NC
Enumeration date
11/26/2012
Last updated
07/23/2021
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