Provider Demographics
NPI:1609567270
Name:MOSLEY-BROOKS, EVELYN
Entity Type:Individual
Prefix:DR
First Name:EVELYN
Middle Name:
Last Name:MOSLEY-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 1:104 VAN GOGH WAY
Mailing Address - Street 2:
Mailing Address - City:ROYAL PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-1580
Mailing Address - Country:US
Mailing Address - Phone:561-373-8452
Mailing Address - Fax:
Practice Address - Street 1:104 VAN GOGH WAY
Practice Address - Street 2:
Practice Address - City:ROYAL PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-1580
Practice Address - Country:US
Practice Address - Phone:561-373-8452
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-16
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty