Organization
BROOKS OF WATER COUNSELING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ESTHER T. ANGLADE LMFT (CLINICAL DIRECTOR)
(601) 706-4021
Entity
Organization
Contact information
Practice address
1700 W GOVERNMENT ST, SUITE 207, BRANDON, MS 39042-2417
(601) 706-4021
Mailing address
1700 W GOVERNMENT ST, SUITE 207, BRANDON, MS 39042-2417
(601) 706-4021
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
T0378
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9082699
AETNA
MS
Enumeration date
08/24/2011
Last updated
08/24/2011
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