Individual
MARK LAWRENCE BROOKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
287 CENTRAL ST, GARDNER, MA 01440-8311
(978) 660-7409
Mailing address
PO BOX 82, GARDNER, MA 01440-0082
(978) 660-7409
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
7949
MA
Other
Enumeration date
06/06/2012
Last updated
06/06/2012
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