Individual
SAVANNAH RENELL BROOKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2085 RUSTIN AVE, RIVERSIDE, CA 92507-2498
(957) 457-3768
Mailing address
23029 GRAY FOX DR, CANYON LAKE, CA 92587-7531
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
05/22/2019
Last updated
05/22/2019
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