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General NPI Number Information
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NPI Number | 1407923014
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Entity Type | Individual
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Provider Name | HEATHER LEE BROOKS OTR
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Gender | Female
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Dates
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Enumeration Date | 11/29/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 700 W ADAMS ST
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City | BOWLING GREEN
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State | MO
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Zip | 63334-2000
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Country | US
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Telephone | 573-324-2331
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Fax |
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Provider Business Mailing Address
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Address Line | 1373 WAGON WHEEL TRL
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City | O FALLON
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State | MO
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Zip | 63366-3749
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Country | US
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Telephone | 636-294-5394
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 2001025908
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License Number State | MO
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