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General NPI Number Information
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NPI Number | 1487034989
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Entity Type | Individual
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Provider Name | MISS ALAINA JEANNE BROKAW
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Gender | Female
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Dates
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Enumeration Date | 06/01/2015
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Last Update Date | 11/20/2023
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Provider Practice Location Address
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Address Line | 49 TOLLAND TURNPIKE #203 F
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City | MANCHESTER
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State | CT
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Zip | 06042
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Country | US
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Telephone | 860-222-7073
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Fax | 860-215-4180
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Provider Business Mailing Address
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Address Line | 89 FINLEY ST
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City | MANCHESTER
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State | CT
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Zip | 06040-5615
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Country | US
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Telephone | 860-222-7073
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Fax |
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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