Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | LC11534 | ME |
NPI | 1003142415 |
---|---|
Provider Name | Sarina Lynn Brooks |
First Address | Whitneyville, ME 04654-4230 |
Second Address | Calais, ME 04619-1404 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/10/2009 |
Last Update Date | 20/10/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
432911799 | (05) | ME |