Provider Demographics
NPI:1740437607
Name:BROOKS, DAWN (COTA/L)
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:
Last Name:BROOKS
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 1:1907 BARK RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:HOPKINSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42240-5187
Mailing Address - Country:US
Mailing Address - Phone:270-348-1224
Mailing Address - Fax:
Practice Address - Street 1:THE WATERS OF CHEATHAM
Practice Address - Street 2:2501 RIVER ROAD
Practice Address - City:ASHLAND CITY
Practice Address - State:TN
Practice Address - Zip Code:37015
Practice Address - Country:US
Practice Address - Phone:615-792-4948
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-22
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYA3883224Z00000X
TN3062224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant