Individual
DR. CRYSTAL ANITA BROOKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
12550 NEW BRITTANY BLVD STE 100, FORT MYERS, FL 33907-3655
(239) 343-9180
(239) 343-9188
Mailing address
PO BOX 2147, FORT MYERS, FL 33902-2147
(239) 343-9180
(239) 343-9188
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PY8201
FL
103TC0700X
Clinical Psychologist
PSY003689
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
120337600
—
FL
Enumeration date
08/14/2018
Last updated
12/07/2023
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