Dr. Crystal Anita Brooks, Ph.D.
Psychologist in Fort Myers, FL. Individual provider (NPI-1).
NPI number1992285415
StatusActive
Last updated in NPPESDec 7, 2023
Details
- NPI
- 1992285415
- Entity type
- Individual (NPI-1)
- Name
- Dr. Crystal Anita Brooks
- Credential
- Ph.D.
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Aug 14, 2018
- Certification date
- Dec 7, 2023
- Last updated
- Dec 7, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103T00000X | Psychologist | PY8201 | FL | Yes |
| 103TC0700X | Psychologist, Clinical | PSY003689 | GA |
Practice location
12550 New Brittany Blvd Ste 100Fort Myers, FL 33907-3655
Phone 239-343-9180 · Fax 239-343-9188
Mailing address
Po Box 2147Fort Myers, FL 33902-2147
Phone 239-343-9180 · Fax 239-343-9188
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