Provider Demographics
NPI:1841055795
Name:BROOKS, CIARA
Entity type:Individual
Prefix:MS
First Name:CIARA
Middle Name:
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 1:1144 E MOMAN AVE UNIT B
Mailing Address - Street 2:
Mailing Address - City:SAPULPA
Mailing Address - State:OK
Mailing Address - Zip Code:74066-3127
Mailing Address - Country:US
Mailing Address - Phone:918-568-3181
Mailing Address - Fax:
Practice Address - Street 1:1144 E MOMAN AVE UNIT B
Practice Address - Street 2:
Practice Address - City:SAPULPA
Practice Address - State:OK
Practice Address - Zip Code:74066-3127
Practice Address - Country:US
Practice Address - Phone:918-568-3181
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-20
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist