Individual
MRS. BROOKE DANA WIMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1612 WEATHERBY LN, PUEBLO, CO 81008-1900
(719) 225-8972
Mailing address
1612 WEATHERBY LN, PUEBLO, CO 81008-1900
(505) 220-1541
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
006780
OH
225X00000X
Occupational Therapist
2467
NM
225XM0800X
Mental Health Occupational Therapist
Primary
0003531
CO
Other
Enumeration date
11/08/2008
Last updated
12/29/2017
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