MEDICARE: BROOKE BRANSCOMBE

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	103TS0200X	School Psychologist

General Provider Information

NPI Number	:	1578418414
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BROOKE BRANSCOMBE

Provider Business Mailing Address
First Line	:	2121 E CAPITOL DR APT 204
Second Line	:
City	:	SHOREWOOD
State	:	WI
Zip	:	53211-2104
Country	:	US
Telephone Number	:	952-381-1053
Fax Number	:

Provider Business Practice Location Address
First Line	:	1228 W LLOYD ST
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53205-1243
Country	:	US
Telephone Number	:	414-702-2147
Fax Number	:

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

Provider Enumeration Date	:	03/04/2026
Last Update Date	:	03/04/2026

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Directions to “ BROOKE BRANSCOMBE ” Practice Location

Language	Start Address	Practice Location

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