Healthcare Provider Details

I. General information

NPI: 1558297986
Provider Name (Legal Business Name): OLIVIA BROOKS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2026
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1583 HIGHWAY 77
GADSDEN AL
35907-0410
US

IV. Provider business mailing address

1583 HIGHWAY 77
GADSDEN AL
35907-0410
US

V. Phone/Fax

Practice location:
  • Phone: 256-459-5499
  • Fax:
Mailing address:
  • Phone: 256-459-5499
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: