Provider Demographics
NPI:1821698168
Name:SZYDLOWSKI, BROOKE BROWN (OTR/L)
Entity Type:Individual
Prefix:
First Name:BROOKE
Middle Name:BROWN
Last Name:SZYDLOWSKI
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1617 COUNTY ROAD 4
Mailing Address - Street 2:
Mailing Address - City:CROSSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35962-3615
Mailing Address - Country:US
Mailing Address - Phone:256-458-0286
Mailing Address - Fax:
Practice Address - Street 1:3683 U.S. HWY 431
Practice Address - Street 2:
Practice Address - City:ALBERTVILLE
Practice Address - State:AL
Practice Address - Zip Code:35962
Practice Address - Country:US
Practice Address - Phone:256-609-6946
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-27
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3940225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist