Provider Demographics
NPI:1760697148
Name:BROOKS, ZOE E (OTR)
Entity Type:Individual
Prefix:
First Name:ZOE
Middle Name:E
Last Name:BROOKS
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:PO BOX 163
Mailing Address - Street 2:
Mailing Address - City:UNION MILLS
Mailing Address - State:IN
Mailing Address - Zip Code:46382-0163
Mailing Address - Country:US
Mailing Address - Phone:219-688-7238
Mailing Address - Fax:219-512-9018
Practice Address - Street 1:608 WATER STREET
Practice Address - Street 2:
Practice Address - City:UNION MILLS
Practice Address - State:IN
Practice Address - Zip Code:46382-0163
Practice Address - Country:US
Practice Address - Phone:219-688-7238
Practice Address - Fax:219-512-9018
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-11
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31000275A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist