Provider Demographics
NPI:1063861201
Name:BROOKS, ARABIA (CPHT)
Entity Type:Individual
Prefix:MS
First Name:ARABIA
Middle Name:
Last Name:BROOKS
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:302 DANIEL BOONE DR
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25301-1126
Mailing Address - Country:US
Mailing Address - Phone:304-542-3188
Mailing Address - Fax:
Practice Address - Street 1:701 LEE ST E
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25301-1706
Practice Address - Country:US
Practice Address - Phone:304-720-8341
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-08
Last Update Date:2016-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVPT0008742183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician