Provider Demographics
NPI:1811247760
Name:BREES, BROOKE ILISE (MS, OTR/L)
Entity type:Individual
Prefix:MRS
First Name:BROOKE
Middle Name:ILISE
Last Name:BREES
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:MS
Other - First Name:BROOKE
Other - Middle Name:ILISE
Other - Last Name:DAMRON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, OTR/L
Mailing Address - Street 1:3905 UNIVERSITY DRIVE
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707
Mailing Address - Country:US
Mailing Address - Phone:919-928-0204
Mailing Address - Fax:919-928-9423
Practice Address - Street 1:3905 UNIVERSITY DR.
Practice Address - Street 2:EMERGE A CHILDS PLACE
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707
Practice Address - Country:US
Practice Address - Phone:919-928-0204
Practice Address - Fax:919-928-9423
Is Sole Proprietor?:No
Enumeration Date:2012-09-18
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8422225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI8422OtherNORTH CAROLINA BOARD OF OCCUPATIONAL THERAPY