Individual
MRS. ELOUISE O. BROOKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
112 LANE AVE S, JACKSONVILLE, FL 32254-3524
(904) 781-4734
Mailing address
PO BOX 41375, JACKSONVILLE, FL 32203-1375
(904) 781-4734
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SW 879
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
677885296
—
FL
Enumeration date
02/05/2014
Last updated
02/05/2014
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