Individual
BROOKE J DURRELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
36914 AVENUE 12 UNIT 10, MADERA, CA 93636-8129
(559) 514-4804
Mailing address
36914 AVENUE 12 UNIT 10, MADERA, CA 93636-8129
(559) 514-4804
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
79898
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000000000
N/A
—
Enumeration date
09/19/2013
Last updated
06/07/2022
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