Provider Demographics
NPI:1760728174
Name:SUTTON, BROOKE (MA, OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:BROOKE
Middle Name:
Last Name:SUTTON
Suffix:
Gender:F
Credentials:MA, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 HILLANDALE AVE
Mailing Address - Street 2:
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22801-1527
Mailing Address - Country:US
Mailing Address - Phone:304-685-1614
Mailing Address - Fax:
Practice Address - Street 1:1003 K ST NW
Practice Address - Street 2:SUITE 700
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20001-4425
Practice Address - Country:US
Practice Address - Phone:202-265-5477
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-13
Last Update Date:2019-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD07417225X00000X
WV1608225X00000X
DCOT010000986225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist