Individual
BROOKE HANNAH ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
701 W 5TH ST, ODESSA, TX 79763-4206
(432) 703-5083
Mailing address
701 W 5TH ST, ODESSA, TX 79763-4206
(432) 703-5083
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
106402907
—
WY
05
—
106402908
—
WY
Enumeration date
11/09/2018
Last updated
04/01/2023
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