Brooke Southivong
Brooke Southivong is an Occupational Therapy Assistant in Fort Wayne, Indiana. Licensed in Indiana. Registered with an NPI since 2013.
- Licensed in
- IN
- In the registry since
- 2013
Practice location Address checks out
884 Beal Brook PassFort Wayne, IN 46814-8236
Phone: (260) 479-0828
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Occupational Therapy Assistant (primary) | Taxonomy 224Z00000X · Licence 32002424A (IN) |
|---|
Record details
| NPI number | 1467887406 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Sole proprietor | No |
| NPI enumerated | September 10, 2013 |
| Last updated in NPPES | February 20, 2014 |
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