Individual
KHADEJIAH BROOKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2470 MALL DR UNIT BCD, NORTH CHARLESTON, SC 29406-6514
(800) 805-6989
Mailing address
2470 MALL DR UNIT BCD, NORTH CHARLESTON, SC 29406-6514
(800) 805-6989
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
07/05/2022
Last updated
07/06/2022
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