Provider Demographics
NPI:1063749471
Name:STRONG, BROOKLYNN MAY (MS)
Entity type:Individual
Prefix:
First Name:BROOKLYNN
Middle Name:MAY
Last Name:STRONG
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:161 SPRING ST
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53964-9068
Mailing Address - Country:US
Mailing Address - Phone:608-296-2139
Mailing Address - Fax:608-296-1590
Practice Address - Street 1:161 SPRING ST
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:WI
Practice Address - Zip Code:53964-9068
Practice Address - Country:US
Practice Address - Phone:608-296-2139
Practice Address - Fax:608-296-1590
Is Sole Proprietor?:No
Enumeration Date:2009-11-05
Last Update Date:2009-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional