Provider Demographics
NPI:1457037566
Name:BROOKS, BRITTANY (COTA)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:
Last Name:BROOKS
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23810 TEX WHEELER AVE
Mailing Address - Street 2:
Mailing Address - City:CHRISTMAS
Mailing Address - State:FL
Mailing Address - Zip Code:32709-8501
Mailing Address - Country:US
Mailing Address - Phone:407-590-8787
Mailing Address - Fax:
Practice Address - Street 1:1705 JESS PARRISH CT
Practice Address - Street 2:
Practice Address - City:TITUSVILLE
Practice Address - State:FL
Practice Address - Zip Code:32796-2158
Practice Address - Country:US
Practice Address - Phone:877-787-3430
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-23
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOTA14732224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant