Provider Demographics
NPI:1710999875
Name:DOOLEY, BROOKE LYNN (MS, RD/LD)
Entity Type:Individual
Prefix:MRS
First Name:BROOKE
Middle Name:LYNN
Last Name:DOOLEY
Suffix:
Gender:F
Credentials:MS, RD/LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1315 E 146TH ST
Mailing Address - Street 2:
Mailing Address - City:GLENPOOL
Mailing Address - State:OK
Mailing Address - Zip Code:74033-3719
Mailing Address - Country:US
Mailing Address - Phone:918-322-6004
Mailing Address - Fax:
Practice Address - Street 1:1315 E 146TH ST
Practice Address - Street 2:
Practice Address - City:GLENPOOL
Practice Address - State:OK
Practice Address - Zip Code:74033-3719
Practice Address - Country:US
Practice Address - Phone:918-322-6004
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-13
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1385133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered