Healthcare Provider Details

I. General information

NPI: 1518887561
Provider Name (Legal Business Name): BROOK LEE PERRY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13819 QUAIL POINTE DR
OKLAHOMA CITY OK
73134-1066
US

IV. Provider business mailing address

1209 W HEFNER RD APT 233
OKLAHOMA CITY OK
73114-7006
US

V. Phone/Fax

Practice location:
  • Phone: 405-849-4151
  • Fax:
Mailing address:
  • Phone: 479-318-2300
  • Fax: 479-763-0059

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: