Provider Demographics
NPI:1467328096
Name:SCOFIELD, BROOKE ELLEN
Entity type:Individual
Prefix:
First Name:BROOKE
Middle Name:ELLEN
Last Name:SCOFIELD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9191 VICTORIA DR
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-2564
Mailing Address - Country:US
Mailing Address - Phone:609-250-8129
Mailing Address - Fax:
Practice Address - Street 1:9191 VICTORIA DR
Practice Address - Street 2:
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21042-2564
Practice Address - Country:US
Practice Address - Phone:609-250-8129
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-13
Last Update Date:2025-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician