Provider Demographics
NPI:1962516021
Name:MEIER, BROOKE VICTORIA (LAC)
Entity type:Individual
Prefix:
First Name:BROOKE
Middle Name:VICTORIA
Last Name:MEIER
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:63 ROBINSON ST
Mailing Address - Street 2:
Mailing Address - City:CABOT
Mailing Address - State:AR
Mailing Address - Zip Code:72023-3433
Mailing Address - Country:US
Mailing Address - Phone:501-843-9233
Mailing Address - Fax:501-843-5696
Practice Address - Street 1:203 WESTPORT DR # B
Practice Address - Street 2:
Practice Address - City:CABOT
Practice Address - State:AR
Practice Address - Zip Code:72023-3657
Practice Address - Country:US
Practice Address - Phone:501-843-9233
Practice Address - Fax:501-843-5696
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA0403012101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor