Individual provider · Type 1 NPI
Deangelo Brooks
Military Health Care Provider · Shreveport, LA
NPI number
1114495603
Active
Practice location
1105 Island Park Blvd Apt 1126
Shreveport, LA 71105-4783
Mailing address
5720 S Lakeshore Dr Apt 605
Shreveport, LA 71119-3930
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Mental Health Counselor | 101YM0800X | None listed |
| Military Health Care Provider Primary | 171000000X | None listed |
Military Health Care Provider: Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes.
Other military health care provider providers in Shreveport
About NPI 1114495603
Deangelo Brooks's National Provider Identifier is 1114495603, issued on Nov 2, 2018. The primary taxonomy on file is Military Health Care Provider (171000000X), and the practice location is in Shreveport, LA. The record was last updated on Sep 22, 2020.