Provider Demographics
NPI:1366867079
Name:GARNES, BROOKE POWELL (MS CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:BROOKE
Middle Name:POWELL
Last Name:GARNES
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:PO BOX 281
Mailing Address - Street 2:
Mailing Address - City:BANCROFT
Mailing Address - State:WV
Mailing Address - Zip Code:25011-0281
Mailing Address - Country:US
Mailing Address - Phone:240-675-8454
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 281
Practice Address - Street 2:
Practice Address - City:BANCROFT
Practice Address - State:WV
Practice Address - Zip Code:25011-0281
Practice Address - Country:US
Practice Address - Phone:240-675-8454
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-04
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1593235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist