Provider Demographics
NPI:1437927233
Name:SAMPSEL, BROOKE E
Entity Type:Individual
Prefix:
First Name:BROOKE
Middle Name:E
Last Name:SAMPSEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4730 SLADE RD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45331-9640
Mailing Address - Country:US
Mailing Address - Phone:937-541-9069
Mailing Address - Fax:
Practice Address - Street 1:212 E MAIN ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:OH
Practice Address - Zip Code:45331-1913
Practice Address - Country:US
Practice Address - Phone:937-541-9069
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-12
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator