Individual
COLLEEN BROOKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
10 LOUISIANA DR, PALM COAST, FL 32137-9705
(386) 237-5626
Mailing address
10 LOUISIANA DR, PALM COAST, FL 32137-9705
(386) 237-5626
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
FL
224Z00000X
Occupational Therapy Assistant
Primary
336255
FL
Other
Enumeration date
12/01/2014
Last updated
06/27/2022
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