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NPI Code Detail

MEDICARE: KEENA BROOKS

MEDICARE: KEENA BROOKS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1588102628
Entity Type Code : Individual
Provider Name (Legal Business Name) : KEENA BROOKS
Provider Business Mailing Address
First Line : 2439 MANHATTAN BLVD STE 301
Second Line :
City : HARVEY
State : LA
Zip : 70058-5359
Country : US
Telephone Number : 504-434-0760
Fax Number : 504-309-4647
Provider Business Practice Location Address
First Line : 2439 MANHATTAN BLVD STE 301
Second Line :
City : HARVEY
State : LA
Zip : 70058-5359
Country : US
Telephone Number : 504-434-0760
Fax Number : 504-309-4647
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/09/2017
Last Update Date : 02/09/2017

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Directions to “ KEENA BROOKS ” Practice Location

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