Basic Information
| Provider Information | |||||||||
| NPI: | 1477287902 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HIGHTOWER | ||||||||
| FirstName: | BROOKE-ALAINA | ||||||||
| MiddleName: | MARINNE | ||||||||
| NamePrefix: | |||||||||
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| Credential: | |||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | HIGHTOWER | ||||||||
| OtherFirstName: | BROOKE-ALAINA | ||||||||
| OtherMiddleName: | MARINNE | ||||||||
| OtherNamePrefix: | |||||||||
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| OtherCredential: | AMFT #107926 | ||||||||
| OtherLastNameType: | 2 | ||||||||
| Mailing Information | |||||||||
| Address1: | 3207 N ARROYO AVE | ||||||||
| Address2: | |||||||||
| City: | FRESNO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 937279114 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5597972107 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1690 W SHAW AVE STE 201 | ||||||||
| Address2: | |||||||||
| City: | FRESNO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 937113519 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8553431057 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/11/2022 | ||||||||
| LastUpdateDate: | 08/01/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/19/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | 107926 | CA | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.