Provider Demographics
NPI:1952629883
Name:BROOKS, BONNIE BORATO (MS,CCC-SLP)
Entity Type:Individual
Prefix:
First Name:BONNIE
Middle Name:BORATO
Last Name:BROOKS
Suffix:
Gender:F
Credentials:MS,CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:784 ARABIAN DR
Mailing Address - Street 2:
Mailing Address - City:LOXAHATCHEE
Mailing Address - State:FL
Mailing Address - Zip Code:33470-3999
Mailing Address - Country:US
Mailing Address - Phone:561-798-8308
Mailing Address - Fax:561-753-4911
Practice Address - Street 1:784 ARABIAN DR
Practice Address - Street 2:
Practice Address - City:LOXAHATCHEE
Practice Address - State:FL
Practice Address - Zip Code:33470-3999
Practice Address - Country:US
Practice Address - Phone:561-798-8308
Practice Address - Fax:561-753-4911
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-17
Last Update Date:2010-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA5376235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist