Doctor Name: | MARA N CANNON-BROOKS |
NPI Number: | 1548316912 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | SLP |
License Number: | SA7645 |
Business Practice Address: | 5920 Beaconpark St Lithia, FL - 335475886 |
Business Phone Number: | 8134137785 |
Business Fax Number: | 4073867132 |
Mailing Address: | 9828 Jasmine Brook Cir, LAND O LAKES |
State: | FL |
Postal Code: | 346386025 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 01/26/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SA7645 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
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 |