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Contact Information

TIM R BROCKETT
56 S MAIN ST
CROSSVILLE, TN38555-4520
 Phone: 440-812-2853
 Fax: 931-707-9474
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatrics

225XP0200X 67 Occupational Therapist in Private Practice
 

Developmental Therapist

222Q00000X
 

Occupational Therapist

225X00000X 67 Occupational Therapist in Private Practice
 

Occupational Therapy Assistant

224Z00000X
Indicates primary specialty

NPI Profile & details for TIM R BROCKETT · (Male)

NPI Number 1093223182
Status Active
Credentials
Entity Individual
Enumeration date 01/11/2018
Last updated 05/19/2025 - More than a year ago
Sole proprietor 1 No
Identifiers
  • FL License # OT22381
  • FL License # OTA16207
  • TN License # 7758
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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