MEDICARE: MS. NORMA RHEA BROOKS DOCTORATE

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	103T00000X	Psychologist	01434	MD
2	103TC0700X	Clinical Psychologist	01434	MD

General Provider Information

NPI Number	:	1851680458
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. NORMA RHEA BROOKS DOCTORATE

Provider Business Mailing Address
First Line	:	2723 WASHINGTON AVE
Second Line	:
City	:	CHEVY CHASE
State	:	MD
Zip	:	20815-3011
Country	:	US
Telephone Number	:	301-588-2858
Fax Number	:

Provider Business Practice Location Address
First Line	:	2723 WASHINGTON AVE
Second Line	:
City	:	CHEVY CHASE
State	:	MD
Zip	:	20815-3011
Country	:	US
Telephone Number	:	301-588-2858
Fax Number	:

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

Provider Enumeration Date	:	04/04/2011
Last Update Date	:	04/04/2011

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