Provider Demographics
NPI:1598350704
Name:NAEYE-BROOKS, JEAN FAY (SLP)
Entity Type:Individual
Prefix:
First Name:JEAN
Middle Name:FAY
Last Name:NAEYE-BROOKS
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6205 VIEW WATER DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27606-9300
Mailing Address - Country:US
Mailing Address - Phone:215-783-0541
Mailing Address - Fax:
Practice Address - Street 1:6205 VIEW WATER DR
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27606-9300
Practice Address - Country:US
Practice Address - Phone:215-783-0541
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-09
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN22001636A235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist