Brooklane Therapy Services
Organization Active NPI Pediatric Occupational Therapist · Young Harris, GA
NPI 1093974412 · NPPES record last updated Jun 2, 2008
Key facts
- NPI
- 1093974412
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pediatric Occupational Therapist 225XP0200X
- License
- 225XP0200 (NC)
- Legal business name
- BROOKLANE THERAPY SERVICES
- Practice address
- 6724 Morgan CT
Young Harris, GA 30582-2551 - Phone
- (706) 379-4068
- Fax
- (706) 379-0640
- NPI assigned
- Jun 2, 2008
- Organization subpart
- No
Authorized official
- Name
- Joseph G. Crockett, OTR/L
- Title
- Occupational Therapist
- Phone
- (706) 379-4068
Practitioners 1
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Occupational Therapist |
225XP0200X | 225XP0200 | NC | Yes |
Addresses
Primary practice location
6724 Morgan CT
Young Harris, GA 30582-2551
Mailing address
6724 Morgan CT
Young Harris, GA 30582-2551
Phone (706) 379-4068
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7212219 | Medicaid | NC | |
| 7301999 | Medicaid | NC |
Other providers in Young Harris, GA
- Paula Jean Boyle
- Brasstown Internal Medicine Group
- Halee Brown
- Deborah Lea Burrell
- Jaclyn C. Collins
- Joseph Gratton Crockett III
- Sharman Louise Cunningham
All providers in Young Harris, GA · Pediatric Occupational Therapist in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 2, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.