Provider Demographics
NPI:1598389843
Name:BROOKS, COLETTE
Entity type:Individual
Prefix:
First Name:COLETTE
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 1:385 GARRISONVILLE RD STE 116
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:VA
Mailing Address - Zip Code:22554-8900
Mailing Address - Country:US
Mailing Address - Phone:540-782-8878
Mailing Address - Fax:
Practice Address - Street 1:385 GARRISONVILLE RD STE 116
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:VA
Practice Address - Zip Code:22554-8900
Practice Address - Country:US
Practice Address - Phone:540-782-8878
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-02
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional