Provider Demographics
NPI:1437393295
Name:BROOKS, BEVERLY GAITHER (MS, CCC - SLP)
Entity Type:Individual
Prefix:MRS
First Name:BEVERLY
Middle Name:GAITHER
Last Name:BROOKS
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 1:2131 CYPRESS DR
Mailing Address - Street 2:
Mailing Address - City:CULPEPER
Mailing Address - State:VA
Mailing Address - Zip Code:22701-4025
Mailing Address - Country:US
Mailing Address - Phone:540-829-4080
Mailing Address - Fax:
Practice Address - Street 1:2131 CYPRESS DR
Practice Address - Street 2:
Practice Address - City:CULPEPER
Practice Address - State:VA
Practice Address - Zip Code:22701-4025
Practice Address - Country:US
Practice Address - Phone:540-829-4080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-23
Last Update Date:2009-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202001594235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist