Provider Demographics
NPI:1861518573
Name:MERCER, BROOKE ASHLEY (COTA)
Entity type:Individual
Prefix:
First Name:BROOKE
Middle Name:ASHLEY
Last Name:MERCER
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 N WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:BOYERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19512-1112
Mailing Address - Country:US
Mailing Address - Phone:610-367-9056
Mailing Address - Fax:
Practice Address - Street 1:30 OLD SCHUYLKILL RD
Practice Address - Street 2:
Practice Address - City:POTTSTOWN
Practice Address - State:PA
Practice Address - Zip Code:19465-7971
Practice Address - Country:US
Practice Address - Phone:610-705-3737
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOP006198224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant