Individual
LA-SHIEKA BROOKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
650 JOEL DR, FORT CAMPBELL, KY 42223-5318
(270) 798-8400
Mailing address
650 JOEL DR, FORT CAMPBELL, KY 42223-5318
(270) 798-8400
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
4818C
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4818C
CLINICAL LICENSE
AL
Enumeration date
08/03/2021
Last updated
08/02/2023
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