Provider Demographics
NPI:1427705003
Name:BROOKS, JACQUALINE MARGARET (MSW)
Entity type:Individual
Prefix:
First Name:JACQUALINE
Middle Name:MARGARET
Last Name:BROOKS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:JACQUALINE
Other - Middle Name:BROOKS
Other - Last Name:ASUQUO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW
Mailing Address - Street 1:603 SISALBED CT
Mailing Address - Street 2:
Mailing Address - City:CAPITOL HEIGHTS
Mailing Address - State:MD
Mailing Address - Zip Code:20743-3337
Mailing Address - Country:US
Mailing Address - Phone:301-828-0835
Mailing Address - Fax:
Practice Address - Street 1:603 SISALBED CT
Practice Address - Street 2:
Practice Address - City:CAPITOL HEIGHTS
Practice Address - State:MD
Practice Address - Zip Code:20743-3337
Practice Address - Country:US
Practice Address - Phone:301-828-0835
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-03
Last Update Date:2022-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD09309104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker