Provider Demographics
NPI:1457621252
Name:BROOKS, SHERRICA SHENNIE (OTA)
Entity Type:Individual
Prefix:MISS
First Name:SHERRICA
Middle Name:SHENNIE
Last Name:BROOKS
Suffix:
Gender:F
Credentials:OTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 BRUCE AVE
Mailing Address - Street 2:5C
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10705-3854
Mailing Address - Country:US
Mailing Address - Phone:347-638-0645
Mailing Address - Fax:
Practice Address - Street 1:111 BRUCE AVE
Practice Address - Street 2:5C
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10705-3854
Practice Address - Country:US
Practice Address - Phone:347-638-0645
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-10
Last Update Date:2012-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist