Provider Demographics
NPI:1144956723
Name:DEMAEGHT-BROOKS, PAMELA HELEN (LLP, SCHOOL PSYCHOLO)
Entity type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:HELEN
Last Name:DEMAEGHT-BROOKS
Suffix:
Gender:F
Credentials:LLP, SCHOOL PSYCHOLO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1864 FRANKLIN RD
Mailing Address - Street 2:
Mailing Address - City:BERKLEY
Mailing Address - State:MI
Mailing Address - Zip Code:48072-1812
Mailing Address - Country:US
Mailing Address - Phone:248-408-7894
Mailing Address - Fax:
Practice Address - Street 1:42140 VAN DYKE AVE STE 190
Practice Address - Street 2:
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48314-3679
Practice Address - Country:US
Practice Address - Phone:313-656-4052
Practice Address - Fax:313-656-4053
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-27
Last Update Date:2022-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6361006188103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical