Provider Demographics
NPI:1740558980
Name:YOLANDA BRUCE BROOKS, PSY.D
Entity Type:Organization
Organization Name:YOLANDA BRUCE BROOKS, PSY.D
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YOLANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:BRUCE BROOKS
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:972-233-2360
Mailing Address - Street 1:PO BOX 800328
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75380-0328
Mailing Address - Country:US
Mailing Address - Phone:972-233-2360
Mailing Address - Fax:
Practice Address - Street 1:4100 ALPHA RD STE 1150
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75244-4335
Practice Address - Country:US
Practice Address - Phone:972-233-2360
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-02
Last Update Date:2011-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2-4386103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty