Provider Demographics
NPI:1437363876
Name:BROOKS, ELIZABETH C (JD IBCLC)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:C
Last Name:BROOKS
Suffix:
Gender:F
Credentials:JD IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:7906 PINE RD
Mailing Address - Street 2:
Mailing Address - City:WYNDMOOR
Mailing Address - State:PA
Mailing Address - Zip Code:19038-8529
Mailing Address - Country:US
Mailing Address - Phone:215-836-9088
Mailing Address - Fax:215-836-0591
Practice Address - Street 1:7906 PINE RD
Practice Address - Street 2:
Practice Address - City:WYNDMOOR
Practice Address - State:PA
Practice Address - Zip Code:19038-8529
Practice Address - Country:US
Practice Address - Phone:215-836-9088
Practice Address - Fax:215-836-0591
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-09
Last Update Date:2011-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN