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Individual

BROOK SMITH DESRIVIERES

Active
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Individual

BROOK SMITH DESRIVIERES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHARM.D.

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
03-01-27524
OH
183500000X
Pharmacist
Primary
5302034164
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03-1-27524
PHARMACIST LICENSE
OH
01
—
15350-40
STATE OF WISCONSIN
WI
01
—
5302034164
PHARMACISTS LICENSE
MI
Enumeration date
08/23/2006
Last updated
06/05/2014
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