Provider Demographics
NPI:1588399653
Name:BROOKS, ERIN ALICIA (OTR/L)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:ALICIA
Last Name:BROOKS
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1154 UNIONVILLE RD
Mailing Address - Street 2:
Mailing Address - City:STEUBEN
Mailing Address - State:ME
Mailing Address - Zip Code:04680-2564
Mailing Address - Country:US
Mailing Address - Phone:207-598-8896
Mailing Address - Fax:
Practice Address - Street 1:4 SCHOOL ST
Practice Address - Street 2:
Practice Address - City:MILBRIDGE
Practice Address - State:ME
Practice Address - Zip Code:04658-3542
Practice Address - Country:US
Practice Address - Phone:207-546-2880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEOT4316225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty