Individual
MR. TIM LOUIS BROOKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
104 IVY LN, PULASKI, TN 38478-4550
(931) 309-7857
(931) 423-0019
Mailing address
1027 LAKE LOGAN RD, ARDMORE, TN 38449-5236
(931) 309-7857
(931) 423-0019
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
1349
AL
101YP2500X
Professional Counselor
Primary
1563
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1349
LPC
AL
01
—
1563
LPC
TN
Enumeration date
05/22/2007
Last updated
07/08/2007
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