Provider Demographics
NPI:1285779918
Name:BROOKS, NELDA WILSON (M ED)
Entity type:Individual
Prefix:MS
First Name:NELDA
Middle Name:WILSON
Last Name:BROOKS
Suffix:
Gender:F
Credentials:M ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1715 PALACE GREEN CT
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77449-2845
Mailing Address - Country:US
Mailing Address - Phone:281-347-4821
Mailing Address - Fax:281-391-6294
Practice Address - Street 1:5818 4TH ST
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77493-2433
Practice Address - Country:US
Practice Address - Phone:281-391-2448
Practice Address - Fax:281-391-6294
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXLPC 9211101YM0800X
TX1668106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist