Individual
BEVERLY JO BROOKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
351 RIVERSIDE DR, MT AIRY, NC 27030-3850
(336) 783-6919
(336) 783-6923
Mailing address
PO BOX 483, PILOT MOUNTAIN, NC 27041-0483
(336) 368-9567
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C002122
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6003318
—
NC
Enumeration date
06/22/2006
Last updated
07/08/2007
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