Individual
REQUISHA DENEE BROOKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNA
Contact information
Practice address
218 E. MLK APT 1, MARIANNA, AR 72360
(870) 821-1415
Mailing address
218 .EAST MARTIN LUTHER KING APT 1, MARIANNA, AR 72360
(870) 821-1415
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
374U00000X
AR
Other
Enumeration date
06/26/2007
Last updated
07/08/2007
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