Provider Demographics
NPI:1992983803
Name:BROOKS, CAROL WOOD (PHD)
Entity type:Individual
Prefix:DR
First Name:CAROL
Middle Name:WOOD
Last Name:BROOKS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:CAROL
Other - Middle Name:S
Other - Last Name:WOOD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:500 N. US HIGHWAY 89
Mailing Address - Street 2:NORTHERN ARIZONA VA HCS (NAVAHCS)
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86313
Mailing Address - Country:US
Mailing Address - Phone:928-445-4860
Mailing Address - Fax:928-776-6054
Practice Address - Street 1:500 N US HIGHWAY 89
Practice Address - Street 2:NORTHERN ARIZONA VA HCS
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86313
Practice Address - Country:US
Practice Address - Phone:928-445-4860
Practice Address - Fax:928-776-6054
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-01
Last Update Date:2015-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6851359-2501103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical