Provider Demographics
NPI:1720527765
Name:BROSKI, ALINA I (COTA/L)
Entity type:Individual
Prefix:
First Name:ALINA
Middle Name:
Last Name:BROSKI
Suffix:I
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 RIDGEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:VALPARAISO
Mailing Address - State:IN
Mailing Address - Zip Code:46385-7810
Mailing Address - Country:US
Mailing Address - Phone:219-252-4909
Mailing Address - Fax:
Practice Address - Street 1:1120 S. CALUMENT ROAD
Practice Address - Street 2:SUITE 3
Practice Address - City:CHESTERTON
Practice Address - State:IN
Practice Address - Zip Code:46304
Practice Address - Country:US
Practice Address - Phone:219-983-9675
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-22
Last Update Date:2017-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant