Individual
KEISA AYANA BROOKS-BACOTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
431 EDGAR CIR, THOMSON, GA 30824-1600
(864) 554-1453
Mailing address
431 EDGAR CIR, THOMSON, GA 30824-1600
(864) 554-1453
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
LPC008161
GA
Other
Enumeration date
02/27/2007
Last updated
03/08/2024
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