Provider Demographics
NPI:1477790921
Name:ADAMS, BROOKE A (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:BROOKE
Middle Name:A
Last Name:ADAMS
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 1:209 9TH ST STE 302
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61104-2235
Mailing Address - Country:US
Mailing Address - Phone:815-489-4470
Mailing Address - Fax:815-490-5858
Practice Address - Street 1:209 9TH ST STE 302
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61104-2235
Practice Address - Country:US
Practice Address - Phone:815-489-4470
Practice Address - Fax:815-490-5858
Is Sole Proprietor?:No
Enumeration Date:2009-01-20
Last Update Date:2009-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.009532235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist