Organization
BROOKE MARTIN LPC PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BROOKE MARTIN (LICENSED PROFESSIONAL COUNSELOR)
(979) 571-6648
Entity
Organization
Contact information
Practice address
3201 UNIVERSITY DR E, SUITE 200, BRYAN, TX 77802-3475
(979) 229-4203
(844) 388-6134
Mailing address
3201 UNIVERSITY DR E, SUITE 200, BRYAN, TX 77802-3475
(979) 229-4203
(844) 388-6134
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
67067
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1598106221
—
TX
Enumeration date
08/29/2015
Last updated
08/29/2015
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