Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 06166 | MD |
Y | 103T00000X | Psychologist | 06166 | MD |
N | 103TP2701X | Group Psychotherapist |
NPI | 1326510439 |
---|---|
Provider Name | Dr. Shemika M Brooks |
First Address | Columbia, MD 21044-3087 |
Second Address | Ellicott City, MD 21042-7877 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/12/2018 |
Last Update Date | 31/12/2018 |