Provider Demographics
NPI:1790350585
Name:BROOKS, ADRIANNA NICOLE (MS, CF-SLP)
Entity Type:Individual
Prefix:
First Name:ADRIANNA
Middle Name:NICOLE
Last Name:BROOKS
Suffix:
Gender:F
Credentials:MS, CF-SLP
Other - Prefix:MRS
Other - First Name:ADRIANNA
Other - Middle Name:NICOLE
Other - Last Name:BROOKS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:101 N POST RD STE A
Mailing Address - Street 2:
Mailing Address - City:MIDWEST CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73130-3605
Mailing Address - Country:US
Mailing Address - Phone:405-397-3550
Mailing Address - Fax:
Practice Address - Street 1:101 N POST RD STE A
Practice Address - Street 2:
Practice Address - City:MIDWEST CITY
Practice Address - State:OK
Practice Address - Zip Code:73130-3605
Practice Address - Country:US
Practice Address - Phone:405-397-3550
Practice Address - Fax:405-455-6505
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-24
Last Update Date:2021-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKCF325235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist