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NPI Code Detail

MEDICARE: MS. MICHELLE LEA BROOKS

MEDICARE: MS. MICHELLE LEA BROOKS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1231H00000XAudiologist2201001223VA

General Provider Information

NPI Number : 1558569434
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MICHELLE LEA BROOKS
Provider Business Mailing Address
First Line : 9526 MEADOWGREEN RD
Second Line :
City : RICHMOND
State : VA
Zip : 23294-5414
Country : US
Telephone Number : 804-217-9944
Fax Number :
Provider Business Practice Location Address
First Line : 8905 THREE CHOPT RD # B
Second Line :
City : RICHMOND
State : VA
Zip : 23229-4614
Country : US
Telephone Number : 804-288-3277
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/03/2007
Last Update Date : 07/08/2007

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Directions to “ MS. MICHELLE LEA BROOKS ” Practice Location

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