Provider Demographics
NPI:1952931685
Name:DOAK, BROOKE DANIELLE (MS CFY-SLP)
Entity Type:Individual
Prefix:
First Name:BROOKE
Middle Name:DANIELLE
Last Name:DOAK
Suffix:
Gender:F
Credentials:MS CFY-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6907 SHAWNEE MISSION PKWY
Mailing Address - Street 2:STE. 207
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66202
Mailing Address - Country:US
Mailing Address - Phone:888-913-1910
Mailing Address - Fax:877-913-1174
Practice Address - Street 1:8908 OLD SANTA FE RD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64138-3911
Practice Address - Country:US
Practice Address - Phone:816-316-7950
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-22
Last Update Date:2020-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2020001228235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist