Provider Demographics
NPI:1205084860
Name:BROCKINGTON-BROWN, PATRICIA GEORGINA (OTR)
Entity type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:GEORGINA
Last Name:BROCKINGTON-BROWN
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:MS
Other - First Name:PATRICIA
Other - Middle Name:GEORGINA
Other - Last Name:BROCKINGTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:7404 EXECUTIVE PL
Mailing Address - Street 2:300B
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-2268
Mailing Address - Country:US
Mailing Address - Phone:301-599-9500
Mailing Address - Fax:301-856-7685
Practice Address - Street 1:8118 GOOD LUCK RD
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-3574
Practice Address - Country:US
Practice Address - Phone:301-599-9500
Practice Address - Fax:301-856-7685
Is Sole Proprietor?:No
Enumeration Date:2008-09-08
Last Update Date:2014-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD02997225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist