Provider Demographics
NPI:1932765575
Name:BROOKS, ARLETHA ANN
Entity Type:Individual
Prefix:
First Name:ARLETHA
Middle Name:ANN
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 1:29455 STELLAMAR DR
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48076-5270
Mailing Address - Country:US
Mailing Address - Phone:313-729-8880
Mailing Address - Fax:
Practice Address - Street 1:29455 STELLAMAR DR
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48076-5270
Practice Address - Country:US
Practice Address - Phone:313-729-8880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-17
Last Update Date:2019-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator