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Individual

MR. EVEREST CAMERON BROOKS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LCSW

Contact information

Practice address
12970 W BLUEMOUND RD, SUITE 105, ELM GROVE, WI 53122-2607
(262) 787-2907
Mailing address
12970 W BLUEMOUND RD, SUITE 105, ELM GROVE, WI 53122-2607
(262) 787-2907

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
7364-123
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
43722400
WI
Enumeration date
08/01/2006
Last updated
10/15/2007
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