Healthcare Provider Details

I. General information

NPI: 1730455247
Provider Name (Legal Business Name): PATRICIA ANN BROOKS LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2012
Last Update Date: 03/29/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

912 CLYDE
AMARILLO TX
79106-4206
US

IV. Provider business mailing address

912 CLYDE ST
AMARILLO TX
79106-4206
US

V. Phone/Fax

Practice location:
  • Phone: 806-468-8900
  • Fax: 806-468-8902
Mailing address:
  • Phone: 806-468-8900
  • Fax: 806-468-8902

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number3951
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: