Provider Demographics
NPI:1376667535
Name:MCLEAN, BROOKE LOVE (PHD)
Entity Type:Individual
Prefix:DR
First Name:BROOKE
Middle Name:LOVE
Last Name:MCLEAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 E HOWARD ST
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91104-2123
Mailing Address - Country:US
Mailing Address - Phone:636-372-7621
Mailing Address - Fax:
Practice Address - Street 1:224 E HOWARD ST
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91104-2123
Practice Address - Country:US
Practice Address - Phone:626-372-7621
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-16
Last Update Date:2010-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner