Provider Demographics
NPI:1417661836
Name:LYONS, BROOKE (SLP)
Entity type:Individual
Prefix:
First Name:BROOKE
Middle Name:
Last Name:LYONS
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:BROOKE
Other - Middle Name:
Other - Last Name:WIEST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3320 TYLERSVILLE RD STE D
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45011-7714
Mailing Address - Country:US
Mailing Address - Phone:513-283-0884
Mailing Address - Fax:
Practice Address - Street 1:3320 TYLERSVILLE RD STE D
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45011-7714
Practice Address - Country:US
Practice Address - Phone:513-283-0884
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-10
Last Update Date:2025-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN528533235Z00000X
ND2298235Z00000X
OH16620235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist