Provider Demographics
NPI:1780135228
Name:BROOKS, VALERIE
Entity type:Individual
Prefix:
First Name:VALERIE
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 1:1637 SPENCE GATE CIR
Mailing Address - Street 2:APT 305
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23456-6184
Mailing Address - Country:US
Mailing Address - Phone:757-237-8257
Mailing Address - Fax:
Practice Address - Street 1:1637 SPENCE GATE CIR
Practice Address - Street 2:APT 305
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23456-6184
Practice Address - Country:US
Practice Address - Phone:757-237-8257
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-19
Last Update Date:2016-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAT61681115347C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle