Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor |
NPI | 1003052960 |
---|---|
Provider Name | Ms. Carla Verlaine Brooks |
First Address | Hartford, CT 06106 |
Second Address | Hartford, CT 06106 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/12/2008 |
Last Update Date | 26/12/2008 |