Provider Demographics
NPI:1609388594
Name:BROOKS, ROSITA W (CMLC)
Entity Type:Individual
Prefix:MRS
First Name:ROSITA
Middle Name:W
Last Name:BROOKS
Suffix:
Gender:F
Credentials:CMLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 292
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:TX
Mailing Address - Zip Code:75966-0292
Mailing Address - Country:US
Mailing Address - Phone:409-622-7420
Mailing Address - Fax:
Practice Address - Street 1:820 COUNTY ROAD 3037
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:TX
Practice Address - Zip Code:75966-6245
Practice Address - Country:US
Practice Address - Phone:409-622-7420
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-31
Last Update Date:2017-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor