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General NPI Number Information
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NPI Number | 1417398389
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Entity Type | Organization
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Legal Business Name | MONICA S. BROOKER, PH.D., LLC
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Dates
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Enumeration Date | 07/08/2013
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 833 N WACO AVE SUITE 200
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City | WICHITA
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State | KS
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Zip | 67203-3989
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Country | US
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Telephone | 316-263-2351
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Fax | 316-263-3685
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Provider Business Mailing Address
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Address Line | 1213 SUNSET DR
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City | MULVANE
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State | KS
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Zip | 67110-1340
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Country | US
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Telephone | 316-990-8887
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | DR. MONICA S. BROOKER
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Credential | LP
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Telephone | 316-263-2351
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | LP 1780
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License Number State | KS
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