Individual
MRS. SANDRA M BROOKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LISW
Contact information
Practice address
11900 FAIRHILL RD, SUITE 300, CLEVELAND, OH 44120-1053
(216) 373-1753
(216) 373-1814
Mailing address
11900 FAIRHILL RD, SUITE 300, CLEVELAND, OH 44120-1053
(216) 373-1753
(216) 373-1814
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
I3385
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0959539
—
OH
01
—
9235411
MEDICARE B
—
Enumeration date
11/07/2007
Last updated
11/07/2007
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