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Individual

ELVIOLET BROOKS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
4548 N STATE ST, JACKSON, MS 39206-5335
(769) 233-3870
Mailing address
4548 N STATE ST, JACKSON, MS 39206-5335
(769) 233-3870

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
A05888
MS

Other

Enumeration date
12/07/2007
Last updated
12/07/2007
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