Provider Demographics
NPI:1093006314
Name:SPENCER-BROOKS, BROOKE ANN (MS, SLP)
Entity Type:Individual
Prefix:MRS
First Name:BROOKE
Middle Name:ANN
Last Name:SPENCER-BROOKS
Suffix:
Gender:F
Credentials:MS, SLP
Other - Prefix:
Other - First Name:BROOKE
Other - Middle Name:ANN
Other - Last Name:SPENCER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS, SLP
Mailing Address - Street 1:213 ROBINSON ST
Mailing Address - Street 2:
Mailing Address - City:WAKEFIELD
Mailing Address - State:RI
Mailing Address - Zip Code:02879-3656
Mailing Address - Country:US
Mailing Address - Phone:401-284-1000
Mailing Address - Fax:
Practice Address - Street 1:213 ROBINSON ST
Practice Address - Street 2:
Practice Address - City:WAKEFIELD
Practice Address - State:RI
Practice Address - Zip Code:02879
Practice Address - Country:US
Practice Address - Phone:401-823-1731
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-20
Last Update Date:2018-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RISP01143235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist