Provider Demographics
NPI:1427273838
Name:BROOKS, JENNIFER R
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:R
Last Name:BROOKS
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:JENNIFER
Other - Middle Name:R
Other - Last Name:BROOKS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:235 PEACHTREE ST STE 400
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30303-1400
Mailing Address - Country:US
Mailing Address - Phone:404-625-8137
Mailing Address - Fax:770-507-5911
Practice Address - Street 1:235 PEACHTREE ST STE 400
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30303-1400
Practice Address - Country:US
Practice Address - Phone:404-625-8137
Practice Address - Fax:770-507-5911
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health