Provider Demographics
NPI:1285961532
Name:BROOKS, DENISE L (PSYD, LP)
Entity type:Individual
Prefix:DR
First Name:DENISE
Middle Name:L
Last Name:BROOKS
Suffix:
Gender:F
Credentials:PSYD, LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:595 FOREST AVE.
Mailing Address - Street 2:STE. 7A
Mailing Address - City:PLYMOUTH
Mailing Address - State:MI
Mailing Address - Zip Code:48170
Mailing Address - Country:US
Mailing Address - Phone:734-765-2885
Mailing Address - Fax:734-446-2716
Practice Address - Street 1:595 FOREST AVE
Practice Address - Street 2:STE. 7A
Practice Address - City:PLYMOUTH
Practice Address - State:MI
Practice Address - Zip Code:48170-1775
Practice Address - Country:US
Practice Address - Phone:734-765-2885
Practice Address - Fax:734-446-2716
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-06
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301013975103TC0700X
MI6301014556103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical