Individual
BROOKE THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LADC
Contact information
Practice address
1010 E 45TH ST, SHAWNEE, OK 74804-2202
(405) 273-1170
(405) 275-5132
Mailing address
7100 WAVERLY AVE, NICHOLS HILLS, OK 73116-5209
(405) 942-5955
(405) 275-5132
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
508
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
508
—
OK
Enumeration date
08/04/2015
Last updated
08/04/2015
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