Individual
BROOKE TOOLEY BRADDOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT, MOT
Contact information
Practice address
9101 BURNET RD STE 103, AUSTIN, TX 78758-5260
(512) 248-2422
(512) 248-2354
Mailing address
9101 BURNET RD STE 103, AUSTIN, TX 78758-5260
(512) 248-2422
(512) 248-2354
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
114627
TX
225XP0200X
Pediatric Occupational Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
342765001
—
TX
Enumeration date
04/18/2012
Last updated
01/18/2019
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