Provider Demographics
NPI:1639557044
Name:SCELFO, BROOKE (OTR)
Entity Type:Individual
Prefix:MISS
First Name:BROOKE
Middle Name:
Last Name:SCELFO
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1539 N PHILIP ST
Mailing Address - Street 2:APT 21
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19122-3816
Mailing Address - Country:US
Mailing Address - Phone:914-424-0530
Mailing Address - Fax:
Practice Address - Street 1:1539 N PHILIP ST
Practice Address - Street 2:APT 21
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19122-3816
Practice Address - Country:US
Practice Address - Phone:914-424-0530
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-18
Last Update Date:2015-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC013767225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics