Provider Demographics
NPI:1194097188
Name:BROOKS, PATRICIA MARIE
Entity type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:MARIE
Last Name:BROOKS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7817 NW ROANRIDGE RD APT B
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64151-5209
Mailing Address - Country:US
Mailing Address - Phone:402-215-3893
Mailing Address - Fax:
Practice Address - Street 1:7817 NW ROANRIDGE RD APT B
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64151-5209
Practice Address - Country:US
Practice Address - Phone:402-215-3893
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-06
Last Update Date:2019-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional