Provider Demographics
NPI:1942341987
Name:EVANS COYNE, BROOKE ELAINE (MS)
Entity Type:Individual
Prefix:MS
First Name:BROOKE
Middle Name:ELAINE
Last Name:EVANS COYNE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 VARINNA DR
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618-1507
Mailing Address - Country:US
Mailing Address - Phone:585-236-7474
Mailing Address - Fax:
Practice Address - Street 1:25 VARINNA DR
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618-1507
Practice Address - Country:US
Practice Address - Phone:585-236-7474
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-11
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014271-2235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist