Provider Demographics
NPI:1144286881
Name:BROOKS, MARGRETT ANN (PHD)
Entity type:Individual
Prefix:DR
First Name:MARGRETT
Middle Name:ANN
Last Name:BROOKS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23175 KITTY COURT
Mailing Address - Street 2:
Mailing Address - City:LEONARDTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20650-2936
Mailing Address - Country:US
Mailing Address - Phone:301-475-7988
Mailing Address - Fax:301-475-3515
Practice Address - Street 1:23175 KITTY COURT
Practice Address - Street 2:
Practice Address - City:LEONARDTOWN
Practice Address - State:MD
Practice Address - Zip Code:20650-2936
Practice Address - Country:US
Practice Address - Phone:301-475-7988
Practice Address - Fax:301-475-3515
Is Sole Proprietor?:No
Enumeration Date:2006-04-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD2768103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD042SMedicare ID - Type Unspecified