Provider Demographics
NPI:1588825897
Name:ADOLFF, BROOKE A (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:BROOKE
Middle Name:A
Last Name:ADOLFF
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4477 REDFERN PL
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27107-3807
Mailing Address - Country:US
Mailing Address - Phone:330-301-0750
Mailing Address - Fax:
Practice Address - Street 1:877 HILL EVERHART RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:NC
Practice Address - Zip Code:27295-9140
Practice Address - Country:US
Practice Address - Phone:336-248-6644
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-19
Last Update Date:2013-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9210235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist