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Provider Information for 1174739528


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RUTHIE BROOKS LPC


Sex: Female

NPI: 1174739528
Last Updated: 2014-09-24
Certification Date:

Details

NameValue
NPI1174739528
Enumeration Date2007-05-15
NPI TypeNPI-1 Individual
Sole ProprietorNO
StatusActive
Mailing Address 50 REGISTRY WAY
FORT MITCHELL, AL 36856
United States

Phone: 334-614-9899 | Fax:
 
Primary Practice Address 2100 COMER AVE
COLUMBUS, GA 31904-8725
United States

Phone: 706-596-5520 | Fax:706-596-5569
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 104100000X - Social Worker