Provider Demographics
NPI:1063131738
Name:BROOK, CAROLINE (MS, SLP-CF)
Entity type:Individual
Prefix:
First Name:CAROLINE
Middle Name:
Last Name:BROOK
Suffix:
Gender:F
Credentials:MS, SLP-CF
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8762 WILL KEITH RD
Mailing Address - Street 2:
Mailing Address - City:TRUSSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35173-2252
Mailing Address - Country:US
Mailing Address - Phone:205-370-1980
Mailing Address - Fax:
Practice Address - Street 1:731 LEIGHTON AVE
Practice Address - Street 2:
Practice Address - City:ANNISTON
Practice Address - State:AL
Practice Address - Zip Code:36207-5761
Practice Address - Country:US
Practice Address - Phone:256-235-5155
Practice Address - Fax:256-235-5590
Is Sole Proprietor?:No
Enumeration Date:2022-08-25
Last Update Date:2022-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist