Provider Demographics
NPI:1821812827
Name:BROOKS, ANGELA R (MAHR)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:R
Last Name:BROOKS
Suffix:
Gender:F
Credentials:MAHR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7802 S 14TH ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85042-6713
Mailing Address - Country:US
Mailing Address - Phone:602-575-9005
Mailing Address - Fax:
Practice Address - Street 1:7802 S 14TH ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85042-6713
Practice Address - Country:US
Practice Address - Phone:602-575-9005
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-14
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No171W00000XOther Service ProvidersContractor
No376J00000XNursing Service Related ProvidersHomemaker
No376K00000XNursing Service Related ProvidersNurse's Aide