Individual
DR. BROOKE LYNN WILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTD, OTR/L
Contact information
Practice address
111 MICHIGAN AVE NW, WASHINGTON, DC 20010-2916
(202) 476-4265
Mailing address
3928 NEW HAMPSHIRE AVE NW, WASHINGTON, DC 20011-7917
(440) 487-6160
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT010001312
DC
225XP0200X
Pediatric Occupational Therapist
OT010001312
DC
Other
Enumeration date
03/08/2018
Last updated
03/08/2018
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