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General NPI Number Information
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NPI Number | 1508383704
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Entity Type | Individual
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Provider Name | KARA RASBERRY BROOKS
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Gender | Female
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Dates
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Enumeration Date | 08/28/2017
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Last Update Date | 08/28/2017
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Provider Practice Location Address
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Address Line | 1910 BLAKE DR
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City | SOUTHSIDE
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State | AL
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Zip | 35907-5259
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Country | US
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Telephone | 256-504-5365
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Fax | 256-504-5365
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Provider Business Mailing Address
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Address Line | 2100 LEIGHTON AVE
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City | ANNISTON
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State | AL
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Zip | 36207-3274
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Country | US
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Telephone | 256-238-0902
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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 | C2776A
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License Number State | AL
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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 | C2776A
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License Number State | AL
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