Healthcare Provider Details

I. General information

NPI: 1972990109
Provider Name (Legal Business Name): MELISSA BYNES BROOKS MBA, CRT, LRT, RPSGT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2015
Last Update Date: 05/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BROOKS HOME SLEEP STUDIES LLC ULM, STUBBS HALL 203, 700 UNIVERSITY AVE.
MONROE LA
71209-6435
US

IV. Provider business mailing address

BROOKS HOME SLEEP STUDIES LLC ULM, STUBBS HALL 203, 700 UNIVERSITY AVE.
MONROE LA
71209-6435
US

V. Phone/Fax

Practice location:
  • Phone: 318-342-1442
  • Fax: 318-625-0605
Mailing address:
  • Phone: 318-342-1442
  • Fax: 318-625-0605

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227800000X
TaxonomyCertified Respiratory Therapist
License NumberLRT.001188
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code246Z00000X
TaxonomyOther Specialist/Technologist
License NumberPOLY.000323
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: