Provider Demographics
NPI:1063514073
Name:DREXLER, GERALDINE BROOKS (MA, CCC-SP)
Entity type:Individual
Prefix:MRS
First Name:GERALDINE
Middle Name:BROOKS
Last Name:DREXLER
Suffix:
Gender:F
Credentials:MA, CCC-SP
Other - Prefix:
Other - First Name:GERI
Other - Middle Name:BROOKS
Other - Last Name:DREXLER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA, CCC-SP
Mailing Address - Street 1:6823 DOMINION LN
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD RANCH
Mailing Address - State:FL
Mailing Address - Zip Code:34202-5027
Mailing Address - Country:US
Mailing Address - Phone:941-538-3571
Mailing Address - Fax:317-522-0010
Practice Address - Street 1:6823 DOMINION LN
Practice Address - Street 2:
Practice Address - City:LAKEWOOD RANCH
Practice Address - State:FL
Practice Address - Zip Code:34202-5027
Practice Address - Country:US
Practice Address - Phone:941-538-3571
Practice Address - Fax:317-522-0010
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA7925235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist