Individual
BROOKE HENRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BS
Contact information
Practice address
119 W VINE ST, OPELOUSAS, LA 70570-5153
(337) 692-3392
(337) 284-3034
Mailing address
119 W VINE ST, OPELOUSAS, LA 70570-5153
(337) 692-3392
(337) 284-3034
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00000000000
—
LA
Enumeration date
12/04/2019
Last updated
06/24/2020
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