Provider Demographics
NPI:1710587233
Name:BILITSKI, BROOKE ANN (M S, CF-SLP)
Entity Type:Individual
Prefix:
First Name:BROOKE
Middle Name:ANN
Last Name:BILITSKI
Suffix:
Gender:F
Credentials:M S, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1415 AMHERST ST
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-3009
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3165 MARTINSBURG PIKE
Practice Address - Street 2:
Practice Address - City:CLEAR BROOK
Practice Address - State:VA
Practice Address - Zip Code:22624-1135
Practice Address - Country:US
Practice Address - Phone:540-662-2289
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-26
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist