Provider Demographics
NPI:1871193706
Name:SIGGERS, BROOKE
Entity Type:Individual
Prefix:
First Name:BROOKE
Middle Name:
Last Name:SIGGERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:829 S GETTYSBURG AVE # 45416
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45417-3569
Mailing Address - Country:US
Mailing Address - Phone:937-262-4633
Mailing Address - Fax:937-293-8150
Practice Address - Street 1:829 S GETTYSBURG AVE # 45416
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45417-3569
Practice Address - Country:US
Practice Address - Phone:937-262-4633
Practice Address - Fax:937-293-8150
Is Sole Proprietor?:No
Enumeration Date:2020-10-29
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator