Healthcare Provider Details

I. General information

NPI: 1861849929
Provider Name (Legal Business Name): BROOKE FRANCES NUTTING
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: BROOKE FRANCES DENISON LACMH

II. Dates (important events)

Enumeration Date: 05/18/2016
Last Update Date: 05/18/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2644 KIRKWOOD HWY SUITE 250
NEWARK DE
19711-7268
US

IV. Provider business mailing address

101 E HAMPSTEAD CT
MIDDLETOWN DE
19709-1634
US

V. Phone/Fax

Practice location:
  • Phone: 302-683-1055
  • Fax:
Mailing address:
  • Phone: 717-385-2634
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberAC-0000111
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: