Doctor Name: | STACY BROOKS |
NPI Number: | 1255733903 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS CCC-SLP |
License Number: | 4056 |
Business Practice Address: | 9224 S Elwood Ave Suite A Jenks, OK - 740372363 |
Business Phone Number: | 9184090157 |
Business Fax Number: | 9182094788 |
Mailing Address: | 29500 E 68th St S, BROKEN ARROW |
State: | OK |
Postal Code: | 740145436 |
Phone Number: | 9186453849 |
Fax Number: | |
NPI Enumeration Date: | 09/24/2014 |
NPI Last Update Date: | 09/24/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 4056 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OK |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |