BROOKE SOUTHIVONG
NPI 1467887406
Occupational Therapy Assistant in Fort Wayne, IN

Active since September 10, 2013
884 BEAL BROOK PASS, FORT WAYNE, IN 46814(260) 479-0828 Get Directions Write a Review

NPPES record last updated: February 20, 2014. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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

NPI1467887406
Entity TypeIndividualFemale
Primary Taxonomy224Z00000X
Provider Legal NameBROOKE SOUTHIVONG
Location Address884 BEAL BROOK PASSFort Wayne, IN 46814-8236
Mailing Address884 Beal Brook PassFort Wayne, IN 46814-8236
Sole ProprietorNo
Enumeration DateSeptember 10, 2013
Last NPPES UpdateFebruary 20, 2014
NPI 1467887406 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyOccupational Therapy AssistantRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code224Z00000X
License Licensed in IN · 32002424A
Definition
An occupational therapy assistant is a person who has graduated from an occupational therapy assistant program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) or predecessor organizations, has successfully completed a period of supervised fieldwork experience required by the accredited occupational therapy assistant program, has passed a nationally recognized entry-level examination for occupational therapy assistants, and fulfills state requirements for licensure, certification, or registration. An occupational therapy assistant provides interventions under the supervision of an occupational therapist which emphasize the therapeutic use of everyday life activities (i.e., occupations) with individuals or groups for the purpose of facilitating participation in roles and situations and in home, school, workplace, community and other settings. Occupational therapy services are provided for the purpose of promoting health and wellness and are provided to those who have or are at risk for developing an illness, injury, disease, disorder, condition, impairment, disability, activity limitation, or participation restriction. Occupational therapy assistants address the physical, cognitive, psychosocial, sensory, and other aspects of occupational performance in a variety of contexts to support engagement in everyday life activities that affect health, well-being, and quality of life.
884 BEAL BROOK PASS, Fort Wayne, IN 46814

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.