Provider Demographics
NPI:1134305261
Name:BARRETT, BROOKE HARTMAN (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:BROOKE
Middle Name:HARTMAN
Last Name:BARRETT
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:736 HARRISON DR
Mailing Address - Street 2:
Mailing Address - City:GETTYSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17325-8961
Mailing Address - Country:US
Mailing Address - Phone:760-814-0179
Mailing Address - Fax:
Practice Address - Street 1:736 HARRISON DR
Practice Address - Street 2:
Practice Address - City:GETTYSBURG
Practice Address - State:PA
Practice Address - Zip Code:17325-8961
Practice Address - Country:US
Practice Address - Phone:760-814-0179
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-18
Last Update Date:2013-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14536235Z00000X
PASL009773235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist