Provider Demographics
NPI:1184311151
Name:WALKER, BROOKE CHRISTINA (COTA/L)
Entity type:Individual
Prefix:MRS
First Name:BROOKE
Middle Name:CHRISTINA
Last Name:WALKER
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:403 PIDGEON HILL RD
Mailing Address - Street 2:
Mailing Address - City:BRANCHVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07826-5701
Mailing Address - Country:US
Mailing Address - Phone:973-271-1490
Mailing Address - Fax:
Practice Address - Street 1:726 E MAIN ST STE 102
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10940-2654
Practice Address - Country:US
Practice Address - Phone:845-394-0080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-20
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOP009689224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant