Provider Demographics
NPI:1154643708
Name:WRIGHT, BROOKE (SLPCCC)
Entity Type:Individual
Prefix:MRS
First Name:BROOKE
Middle Name:
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:SLPCCC
Other - Prefix:
Other - First Name:BROOKE
Other - Middle Name:
Other - Last Name:SCHRIEFER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3530 LEMAY FERRY RD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63125-4424
Mailing Address - Country:US
Mailing Address - Phone:314-845-7751
Mailing Address - Fax:314-845-7752
Practice Address - Street 1:3530 LEMAY FERRY RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63125-4424
Practice Address - Country:US
Practice Address - Phone:314-845-7751
Practice Address - Fax:314-845-7752
Is Sole Proprietor?:No
Enumeration Date:2010-02-24
Last Update Date:2010-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2002013052235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist