Provider Demographics
NPI:1639571425
Name:BROGAN, CAITLIN (MS, OTR/L)
Entity type:Individual
Prefix:
First Name:CAITLIN
Middle Name:
Last Name:BROGAN
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 SKILES BLVD
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19382-7321
Mailing Address - Country:US
Mailing Address - Phone:800-578-7906
Mailing Address - Fax:855-251-8775
Practice Address - Street 1:1000 N WEST ST
Practice Address - Street 2:SUITE 1200
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19801-1050
Practice Address - Country:US
Practice Address - Phone:800-578-7906
Practice Address - Fax:855-251-8775
Is Sole Proprietor?:No
Enumeration Date:2014-09-23
Last Update Date:2014-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEU1-0001479225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist