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Individual

SHIRLEY BROOKS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS, RD, LDN

Contact information

Practice address
360 HUNTINGTON AVE, 208 RB, BOSTON, MA 02115-5005
(857) 249-4780
Mailing address
2777 N STEMMONS FWY STE 400, DALLAS, TX 75207-2265
(857) 249-4780

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
3308
MA
133V00000X
Registered Dietitian
Primary
DT07342
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3308
REGISTERED DIETITIAN LICENSE
MA
01
DT07342
RD LICENSE
TX
Enumeration date
06/05/2012
Last updated
05/08/2014
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