Provider Demographics
NPI:1720961790
Name:BRUBAKER, ZOE LOUISE (OTD, OTR)
Entity type:Individual
Prefix:
First Name:ZOE
Middle Name:LOUISE
Last Name:BRUBAKER
Suffix:
Gender:F
Credentials:OTD, OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8609 S HONEY CREEK RD
Mailing Address - Street 2:
Mailing Address - City:MUNCIE
Mailing Address - State:IN
Mailing Address - Zip Code:47302-8152
Mailing Address - Country:US
Mailing Address - Phone:765-215-4984
Mailing Address - Fax:
Practice Address - Street 1:1751 WESLEY RD
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:IN
Practice Address - Zip Code:46706-3647
Practice Address - Country:US
Practice Address - Phone:260-925-5494
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-28
Last Update Date:2025-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31008784A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist