Individual
DEIDRE L. BROOKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PC
Contact information
Practice address
65 MESSIMER DR, NEWARK, OH 43055-1874
(740) 522-8477
(740) 788-3424
Mailing address
PO BOX 4670, NEWARK, OH 43058-4670
(740) 522-8477
(740) 788-3424
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
C.0800136
OH
101YP2500X
Professional Counselor
C.0800136-CR
OH
Other
Enumeration date
11/02/2012
Last updated
11/04/2014
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