Provider Demographics
NPI:1255060869
Name:BROADBOOKS, SAVANNAH A
Entity type:Individual
Prefix:
First Name:SAVANNAH
Middle Name:A
Last Name:BROADBOOKS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 17TH ST SE APT 203
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20003-1764
Mailing Address - Country:US
Mailing Address - Phone:812-603-0874
Mailing Address - Fax:
Practice Address - Street 1:1227 4TH ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-3431
Practice Address - Country:US
Practice Address - Phone:202-543-8477
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-08
Last Update Date:2024-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCSLP200001480235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist