Provider Demographics
NPI:1740818624
Name:GREENBROOK, EMILY MARIE (MS)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:MARIE
Last Name:GREENBROOK
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 1:21840 IDEN AVE N
Mailing Address - Street 2:
Mailing Address - City:FOREST LAKE
Mailing Address - State:MN
Mailing Address - Zip Code:55025-9113
Mailing Address - Country:US
Mailing Address - Phone:651-230-4759
Mailing Address - Fax:
Practice Address - Street 1:2248 N ALMA SCHOOL RD STE 102
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-2488
Practice Address - Country:US
Practice Address - Phone:480-935-0614
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-27
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist