Individual
MS. BETTY LEE BROOKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS LCPC
Contact information
Practice address
1811 LAURELWOOD DR, HAILEY, ID 83333
(208) 309-0237
(208) 788-9317
Mailing address
PO BOX 981, HAILEY, ID 83333
(208) 309-0237
(208) 788-9317
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LCPC 3366
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Q6363
BLUE CROSS
ID
Enumeration date
04/24/2007
Last updated
07/08/2007
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