Healthcare Provider Details

I. General information

NPI: 1467932111
Provider Name (Legal Business Name): MS. APRIL YVONNE BROOKS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/21/2018
Last Update Date: 08/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5900 N LILLEY RD
CANTON MI
48187-3776
US

IV. Provider business mailing address

31481 BLOCK ST APT 204
GARDEN CITY MI
48135-1942
US

V. Phone/Fax

Practice location:
  • Phone: 734-981-3709
  • Fax: 734-981-5384
Mailing address:
  • Phone: 313-704-7742
  • Fax: 734-981-5384

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247200000X
TaxonomyOther Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: