Brooks, Constance Moore

Brooks, Constance Moore is an sole proprietor health care provider with primary practice located at 205 Portland St , Columbia MO 65201-6521. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Clinical Child & Adolescent. Behavioral Health & Social Service Providers / Clinical Child & Adolescent is her primary health care specialty. Brooks, Constance Moore can be contacted via phone (573) 884-6052.

Contact Information

Primary practice address
205 Portland St Columbia MO 65201-6521
Phone: (573) 884-6052
Fax: (573) 884-6421
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 2007028043 Missouri
Behavioral Health & Social Service Providers / Clinical Child & Adolescent 103TC2200X 2007028043 Missouri

Profile Details

NPI number 1750470506
LBN Legal business name Brooks, Constance Moore
Credentials PHD
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 12th, 2006
Last updated Feb 15th, 2018 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1750470506 NPPES
Missouri MEDICAID 494-73-8610
Missouri Other 11614969

Popular Providers