Individual
BROOKE PARISH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2400 S AVENUE A, YUMA, AZ 85364-7127
(928) 336-2000
(505) 272-8692
Mailing address
PO BOX 26666, PHS PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 923-6770
(505) 923-5354
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
2003-0752
NM
208M00000X
Hospitalist Physician
Primary
MD2003-0752
NM
Other
Enumeration date
07/30/2006
Last updated
04/13/2026
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