Healthcare Provider Details

I. General information

NPI: 1316825839
Provider Name (Legal Business Name): BROOKE KATHLEEN DANNENFELDT OTD, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/22/2025
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3113 BEL AIRE RD
DES MOINES IA
50310-4904
US

IV. Provider business mailing address

3113 BEL AIRE RD
DES MOINES IA
50310-4904
US

V. Phone/Fax

Practice location:
  • Phone: 515-422-3050
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number134043
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number17917
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: