MEDICARE: BROOKE ANNE OCHOA OT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	OT007269	GA

General Provider Information

NPI Number	:	1124583620
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BROOKE ANNE OCHOA OT

Provider Business Mailing Address
First Line	:	6397 LEE HWY STE 300
Second Line	:
City	:	CHATTANOOGA
State	:	TN
Zip	:	37421-4915
Country	:	US
Telephone Number	:	423-238-7217
Fax Number	:	423-238-3473

Provider Business Practice Location Address
First Line	:	3640 MUNDY MILL RD STE 102B
Second Line	:
City	:	GAINESVILLE
State	:	GA
Zip	:	30504-8226
Country	:	US
Telephone Number	:	770-287-8821
Fax Number	:	770-287-8797

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/08/2019
Last Update Date	:	07/20/2022

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Directions to “ BROOKE ANNE OCHOA OT” Practice Location

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