Individual
PAMELA BROOKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
765 W LIMBERLOST DR, #5, TUCSON, AZ 85705-1564
(520) 312-2625
Mailing address
765 W LIMBERLOST DR, #5, TUCSON, AZ 85705-1564
(520) 312-2625
Taxonomy
Speciality
Code
Description
License number
State
385HR2055X
Child Mental Illness Respite Care
Primary
4515175
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4515175
PROFESSIONAL FOSTER CARE LICENSE
AZ
Enumeration date
05/20/2013
Last updated
05/20/2013
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