Provider Demographics
NPI:1093828279
Name:BROOKE, ANTHONY D
Entity Type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:D
Last Name:BROOKE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:953 S REBECCA DR
Mailing Address - Street 2:
Mailing Address - City:PALMER
Mailing Address - State:AK
Mailing Address - Zip Code:99645-9361
Mailing Address - Country:US
Mailing Address - Phone:907-746-8071
Mailing Address - Fax:
Practice Address - Street 1:1750 PATTERSON ST
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99504-2750
Practice Address - Country:US
Practice Address - Phone:907-742-0387
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health