Individual
DENNIS BROOKS PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
TCADC
Contact information
Practice address
2705 OLIVET CHURCH RD, PADUCAH, KY 42001-9755
(270) 443-0096
(270) 443-0080
Mailing address
2705 OLIVET CHURCH RD, PADUCAH, KY 42001-9755
(270) 443-0096
(270) 443-0080
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
172662
KY
Other
Enumeration date
09/25/2018
Last updated
09/25/2018
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