Provider Demographics
NPI:1629625983
Name:BROOKES, KRISTEN HAYLEY (RDT, LCAT)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:HAYLEY
Last Name:BROOKES
Suffix:
Gender:F
Credentials:RDT, LCAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:759 PRESIDENT ST APT 2I
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-1362
Mailing Address - Country:US
Mailing Address - Phone:347-342-2655
Mailing Address - Fax:
Practice Address - Street 1:386 1ST ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-2501
Practice Address - Country:US
Practice Address - Phone:718-369-3099
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-21
Last Update Date:2019-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001535221700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist