Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist |
NPI | 1104360049 |
---|---|
Provider Name | Dr. Calisha Brooks |
First Address | Brentwood, TN 37027-8828 |
Second Address | Brentwood, TN 37027-8828 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/12/2016 |
Last Update Date | 12/12/2016 |