Provider Demographics
NPI:1528536513
Name:BROOKE, BROOKE ADRIANNE (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:BROOKE
Middle Name:ADRIANNE
Last Name:BROOKE
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MISS
Other - First Name:BROOKE
Other - Middle Name:ADRIANNE
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:2003 123RD RD
Mailing Address - Street 2:
Mailing Address - City:GRESHAM
Mailing Address - State:NE
Mailing Address - Zip Code:68367-5010
Mailing Address - Country:US
Mailing Address - Phone:402-366-5414
Mailing Address - Fax:
Practice Address - Street 1:2222 N LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:NE
Practice Address - Zip Code:68467-1030
Practice Address - Country:US
Practice Address - Phone:402-362-0436
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-07
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2272225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist