Provider Demographics
NPI:1558451286
Name:BROOKS, ALLISON CORI (MS)
Entity type:Individual
Prefix:MRS
First Name:ALLISON
Middle Name:CORI
Last Name:BROOKS
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 1:7025 BERACASA WAY STE 105G
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-3465
Mailing Address - Country:US
Mailing Address - Phone:561-702-6141
Mailing Address - Fax:561-258-2777
Practice Address - Street 1:7025 BERACASA WAY STE 105G
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-3465
Practice Address - Country:US
Practice Address - Phone:561-702-6141
Practice Address - Fax:561-258-2777
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 5357235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL885325900Medicaid