MEDICARE: EMILY BROOKS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1194599340
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILY BROOKS

Provider Business Mailing Address
First Line	:	1707 LINWOOD DR STE G1707
Second Line	:
City	:	PARAGOULD
State	:	AR
Zip	:	72450-5364
Country	:	US
Telephone Number	:	870-604-4455
Fax Number	:

Provider Business Practice Location Address
First Line	:	1801 CENTRAL AVE STE B
Second Line	:
City	:	HOT SPRINGS
State	:	AR
Zip	:	71901-6800
Country	:	US
Telephone Number	:	870-604-4455
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/08/2023
Last Update Date	:	11/08/2023

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Directions to “ EMILY BROOKS ” Practice Location

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