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General NPI Number Information
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NPI Number | 1902563752
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Entity Type | Individual
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Provider Name | MRS. BROOKE ELIZABETH LANDS
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Gender | Female
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Dates
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Enumeration Date | 11/29/2021
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Last Update Date | 05/27/2025
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Provider Practice Location Address
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Address Line | 3595 E FOUNTAIN BLVD
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City | COLORADO SPRINGS
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State | CO
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Zip | 80910-1733
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Country | US
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Telephone | 719-623-7190
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Fax |
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Provider Business Mailing Address
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Address Line | 6407 JARMON RD UNIT 100
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City | GUNTERSVILLE
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State | AL
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Zip | 35976-9342
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Country | US
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Telephone | 256-673-8277
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 6651G
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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 | 0009926330
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License Number State | CO
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