Provider Demographics
NPI:1437380458
Name:BROOKS, SONYA MONIQUE
Entity Type:Individual
Prefix:
First Name:SONYA
Middle Name:MONIQUE
Last Name:BROOKS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1785 WARRENSVILLE CENTER RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44121-2642
Mailing Address - Country:US
Mailing Address - Phone:216-240-4452
Mailing Address - Fax:
Practice Address - Street 1:1785 WARRENSVILLE CENTER RD
Practice Address - Street 2:
Practice Address - City:SOUTH EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44121-2642
Practice Address - Country:US
Practice Address - Phone:216-240-4452
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-07
Last Update Date:2009-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH125640164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse