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NPI Code Detail

MEDICARE: BROOKE POWERS

MEDICARE:   BROOKE  POWERS
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
1224Z00000XOccupational Therapy Assistant

General Provider Information

NPI Number : 1225793292
Entity Type Code : Individual
Provider Name (Legal Business Name) : BROOKE POWERS
Provider Business Mailing Address
First Line : 11618 FRANKLINVILLE RD
Second Line :
City : UPPER FALLS
State : MD
Zip : 21156-1905
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 12230 ROUNDWOOD RD
Second Line :
City : LUTHERVILLE
State : MD
Zip : 21093-3233
Country : US
Telephone Number : 410-252-0880
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/04/2021
Last Update Date : 11/04/2021

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Directions to “ BROOKE POWERS ” Practice Location

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