Individual
JODENE BROOKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
680
AL
103TC0700X
Clinical Psychologist
Primary
680
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000073932
—
AL
05
—
000074714
—
AL
01
—
1255493573
TRICARE SOUTH
AL
01
—
510-73932
BCBS
AL
01
—
510-74714
BCBS
AL
01
—
515-93052
FEDERAL BC
AL
Enumeration date
12/14/2006
Last updated
12/29/2015
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