Individual
ELEZYA A BROOKINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
24 GUERETTE RD, WINTHROP, ME 04364-1365
(817) 933-2099
Mailing address
24 GUERETTE RD, WINTHROP, ME 04364-1365
(207) 458-1963
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LC7189
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LC7189
—
ME
Enumeration date
08/18/2021
Last updated
03/18/2024
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