Provider Demographics
NPI:1922423128
Name:BROOKER, DEBRA (LBSW-IPR)
Entity Type:Individual
Prefix:MS
First Name:DEBRA
Middle Name:
Last Name:BROOKER
Suffix:
Gender:F
Credentials:LBSW-IPR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3411
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78463-3411
Mailing Address - Country:US
Mailing Address - Phone:361-877-5085
Mailing Address - Fax:
Practice Address - Street 1:1105 FLORIDA AVE
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78404-3749
Practice Address - Country:US
Practice Address - Phone:361-857-2559
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-25
Last Update Date:2014-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX30768104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker