Provider Demographics
NPI:1326324294
Name:BROOKINS, WILLERMINE (COUNSELOR-CASE MGMT)
Entity Type:Individual
Prefix:
First Name:WILLERMINE
Middle Name:
Last Name:BROOKINS
Suffix:
Gender:F
Credentials:COUNSELOR-CASE MGMT
Other - Prefix:
Other - First Name:WILLERMINE
Other - Middle Name:
Other - Last Name:PETTWAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:COUNSELOR-CASE MGMT
Mailing Address - Street 1:15818 SW WARFIELD BLVD
Mailing Address - Street 2:
Mailing Address - City:INDIANTOWN
Mailing Address - State:FL
Mailing Address - Zip Code:34956-3513
Mailing Address - Country:US
Mailing Address - Phone:772-940-6755
Mailing Address - Fax:772-446-9744
Practice Address - Street 1:15818 SW WARFIELD BLVD
Practice Address - Street 2:
Practice Address - City:INDIANTOWN
Practice Address - State:FL
Practice Address - Zip Code:34956-3513
Practice Address - Country:US
Practice Address - Phone:772-940-6755
Practice Address - Fax:772-446-9744
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-24
Last Update Date:2021-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator