Provider Demographics
NPI:1861849929
Name:NUTTING, BROOKE FRANCES
Entity Type:Individual
Prefix:
First Name:BROOKE
Middle Name:FRANCES
Last Name:NUTTING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:BROOKE
Other - Middle Name:FRANCES
Other - Last Name:DENISON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LACMH
Mailing Address - Street 1:101 E HAMPSTEAD CT
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:DE
Mailing Address - Zip Code:19709-1634
Mailing Address - Country:US
Mailing Address - Phone:717-385-2634
Mailing Address - Fax:
Practice Address - Street 1:2644 KIRKWOOD HWY
Practice Address - Street 2:SUITE 250
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19711-7268
Practice Address - Country:US
Practice Address - Phone:302-683-1055
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-18
Last Update Date:2016-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEAC-0000111101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health