Healthcare Provider Details

I. General information

NPI: 1699699207
Provider Name (Legal Business Name): BROOKE MYERS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2026
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

385 VIKING WAY
ASHVILLE OH
43103-9638
US

IV. Provider business mailing address

412 CHURCH ST
CHILLICOTHEE OH
45601-1622
US

V. Phone/Fax

Practice location:
  • Phone: 740-983-5000
  • Fax:
Mailing address:
  • Phone: 260-416-2602
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberS.2512758
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: