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General NPI Number Information
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NPI Number | 1427575034
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Entity Type | Organization
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Legal Business Name | STEVEN BROOKS PC
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Dates
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Enumeration Date | 08/24/2017
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Last Update Date | 10/12/2023
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Provider Practice Location Address
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Address Line | 1133 S STATE RD STE 5
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City | DAVISON
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State | MI
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Zip | 48423-1963
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Country | US
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Telephone | 810-278-6693
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Fax | 810-652-6263
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Provider Business Mailing Address
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Address Line | 1133 S STATE RD STE 5
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City | DAVISON
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State | MI
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Zip | 48423-1963
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Country | US
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Telephone | 810-278-6693
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Fax | 810-652-6263
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | STEVEN MARK BROOKS
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Credential | MS, LLP
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Telephone | 810-278-6693
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | 6301007639
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License Number State | MI
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