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General NPI Number Information
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NPI Number | 1679377436
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Entity Type | Individual
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Provider Name | DAVID JERMAINE BROOKS RBT
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Gender | Male
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Dates
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Enumeration Date | 04/02/2025
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Last Update Date | 05/14/2025
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Provider Practice Location Address
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Address Line | 505 COURTLAND ST NE UNIT 916
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City | ATLANTA
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State | GA
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Zip | 30308-2424
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Country | US
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Telephone | 423-544-2461
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Fax |
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Provider Business Mailing Address
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Address Line | 66 TREEVIEW DR APT D
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City | LITHONIA
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State | GA
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Zip | 30038-1392
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Country | US
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Telephone | 423-544-2461
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | RBT025-422008
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License Number State | GA
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