Provider Demographics
NPI:1558895524
Name:GALINDO, BROOKE ANN (COTA/L)
Entity Type:Individual
Prefix:MRS
First Name:BROOKE
Middle Name:ANN
Last Name:GALINDO
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:MISS
Other - First Name:BROOKE
Other - Middle Name:ANN
Other - Last Name:HAYMORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:349 HERMITAGE DR APT A
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24541-5856
Mailing Address - Country:US
Mailing Address - Phone:434-770-7154
Mailing Address - Fax:
Practice Address - Street 1:2526 N MAIN ST
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24540
Practice Address - Country:US
Practice Address - Phone:434-836-9510
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-17
Last Update Date:2018-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC224Z00000X
VA0131001767224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant