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General NPI Number Information
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NPI Number | 1346491727
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Entity Type | Individual
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Provider Name | BROOKE M DEY MA, LPC
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Gender | Female
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Dates
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Enumeration Date | 10/03/2008
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Last Update Date | 02/14/2022
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Provider Practice Location Address
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Address Line | 2301 RIVERSIDE DR STE B11
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City | GREEN BAY
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State | WI
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Zip | 54301-1957
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Country | US
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Telephone | 920-544-6818
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Fax | 920-212-4997
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Provider Business Mailing Address
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Address Line | 2417 MANITOWOC RD
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City | GREEN BAY
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State | WI
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Zip | 54311-5323
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Country | US
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Telephone | 920-544-6818
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Fax | 920-212-4997
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 5388-125
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 5388-125
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License Number State | WI
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