Brocklehurst, Angelika W
Brocklehurst, Angelika W is an sole proprietor health care provider with primary practice located at 114 New St , Decatur GA 30030-4132. She recently has 2 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist is her primary health care specialty. Brocklehurst, Angelika W can be contacted via phone (404) 769-7584.Contact Information
Primary practice address
114 New St
Decatur GA 30030-4132
Phone: (404) 769-7584
Fax: (404) 363-9263
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist | 225X00000X | OT004318 | Georgia |
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics | 225XP0200X | OT004318 | Georgia |
Profile Details
| NPI number | 1861690489 |
|---|---|
| LBN Legal business name | Brocklehurst, Angelika W |
| Credentials | OTR/L |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 5th, 2007 |
| Last updated | Oct 10th, 2014 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1861690489 | NPPES |
| Georgia | MEDICAID | 863580759A |
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