Provider Demographics
NPI:1386823193
Name:LEAR, BROOKE (OT)
Entity Type:Individual
Prefix:
First Name:BROOKE
Middle Name:
Last Name:LEAR
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:314 CEDAR STREET
Mailing Address - Street 2:SUITE 114
Mailing Address - City:AMESBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01913
Mailing Address - Country:US
Mailing Address - Phone:978-378-4848
Mailing Address - Fax:978-378-4633
Practice Address - Street 1:314 CEDAR STREET
Practice Address - Street 2:SUITE 114
Practice Address - City:AMESBURY
Practice Address - State:MA
Practice Address - Zip Code:01913
Practice Address - Country:US
Practice Address - Phone:978-378-4848
Practice Address - Fax:978-378-4633
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-29
Last Update Date:2011-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1768225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAOT0262OtherBLUE CROSS MA.
MAOT0262OtherBLUE CROSS MA.