Brooke Ashley Umfleet
Individual provider Active NPI Occupational Therapist · Patterson, MO
NPI 1609419688 · NPPES record last updated Oct 23, 2019
Key facts
- NPI
- 1609419688
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- License
- 2018005494 (MO)
- Practice address
- RR 1 Box 11470
Patterson, MO 63956-8712 - Phone
- (573) 225-7174
- NPI assigned
- Oct 23, 2019
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2018005494 | MO | MD | Occupational Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 2018005494 | MO | Yes |
Addresses
Primary practice location
RR 1 Box 11470
Patterson, MO 63956-8712
Mailing address
RR 1 Box 11470
Patterson, MO 63956-8712
Phone (573) 225-7174
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 397178 | Other | NATIONAL BOARD FOR CERTIFICATION IN OCCUPATIONAL THERAPY |
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 23, 2019. 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.