Provider Demographics
NPI:1851695613
Name:BROOKS, SONIA (CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:SONIA
Middle Name:
Last Name:BROOKS
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 1:689 VANDAM STREET
Mailing Address - Street 2:
Mailing Address - City:NORTH WOODMERE
Mailing Address - State:NY
Mailing Address - Zip Code:11581
Mailing Address - Country:US
Mailing Address - Phone:917-576-6725
Mailing Address - Fax:516-569-0363
Practice Address - Street 1:689 VANDAM STREET
Practice Address - Street 2:
Practice Address - City:NORTH WOODMERE
Practice Address - State:NY
Practice Address - Zip Code:11581
Practice Address - Country:US
Practice Address - Phone:917-576-6725
Practice Address - Fax:516-569-0363
Is Sole Proprietor?:No
Enumeration Date:2011-01-07
Last Update Date:2011-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010785-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist