Provider Demographics
NPI:1760183412
Name:BROOKS, AMY NORTHROP (PHD, MS)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:NORTHROP
Last Name:BROOKS
Suffix:
Gender:F
Credentials:PHD, MS
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:VIRGINIA
Other - Last Name:NORTHROP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD, MS
Mailing Address - Street 1:1101 E MARSHALL ST OFC 11-033
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23298-5008
Mailing Address - Country:US
Mailing Address - Phone:804-628-3507
Mailing Address - Fax:
Practice Address - Street 1:1101 E MARSHALL ST OFC 11-033
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23298-5008
Practice Address - Country:US
Practice Address - Phone:804-628-3507
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-10
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0139000559170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS