BROOKE SOUTHIVONG
NPI 1467887406
Occupational Therapy Assistant in Fort Wayne, IN
About Brooke Southivong NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
BROOKE SOUTHIVONG (NPI 1467887406) is an individual occupational therapy assistant in Fort Wayne, Indiana, licensed in Indiana (32002424A) and active in the NPI registry since September 2013.
NPPES Registry Identity
Specialties & Licenses
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Brooke Southivong's NPI number?
The NPI number for Brooke Southivong is 1467887406. It was assigned to this individual provider in the NPPES registry on September 10, 2013.
Where is Brooke Southivong located?
Brooke Southivong practices at 884 Beal Brook Pass, Fort Wayne, IN 46814. The listed phone number is (260) 479-0828.
What is Brooke Southivong's specialty?
The primary specialty registered for this NPI is Occupational Therapy Assistant with taxonomy code 224Z00000X.
When was this NPI record last updated?
The NPPES record for Brooke Southivong was last updated on February 20, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.