Individual
MRS. SHELLY RENEE BROOKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
1772 STIEGER LAKE LANE, VICTORIA, MN 55386
(952) 443-9888
(952) 443-9804
Mailing address
PO BOX 34, VICTORIA, MN 55386
(952) 443-9888
(952) 443-9804
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
100343
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
146K7BR
BCBS MN
—
01
—
6404312
MEDICA
—
01
—
HP41507
HEALTH PARTNERS
—
Enumeration date
09/08/2006
Last updated
07/08/2007
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