Provider Demographics
NPI:1376166058
Name:SAGHERIAN, BROOKE SHEENA (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:BROOKE
Middle Name:SHEENA
Last Name:SAGHERIAN
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 1:6849 POST OAK DR
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48322-3835
Mailing Address - Country:US
Mailing Address - Phone:248-497-2205
Mailing Address - Fax:
Practice Address - Street 1:5600 W MAPLE RD STE B209
Practice Address - Street 2:
Practice Address - City:WEST BLOOMFIELD
Practice Address - State:MI
Practice Address - Zip Code:48322-3707
Practice Address - Country:US
Practice Address - Phone:248-497-2205
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-28
Last Update Date:2024-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7101006791235Z00000X
235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist