Individual
MS. SUSAN HUSS BROOKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MFT LPC CSAC
Contact information
Practice address
826 MONASKON RD, LIVELY, VA 22507
(804) 462-7919
Mailing address
PO BOX 504, LIVELY, VA 22507
(804) 462-7919
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0701001902
VA
Other
Enumeration date
06/06/2007
Last updated
07/08/2007
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