Provider Demographics
NPI:1154991339
Name:FUSER, BROOKLYN BETTY (SLPA)
Entity type:Individual
Prefix:
First Name:BROOKLYN
Middle Name:BETTY
Last Name:FUSER
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51801 E 225 RD
Mailing Address - Street 2:
Mailing Address - City:AFTON
Mailing Address - State:OK
Mailing Address - Zip Code:74331-2817
Mailing Address - Country:US
Mailing Address - Phone:918-541-0622
Mailing Address - Fax:
Practice Address - Street 1:2225 N MAIN ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:OK
Practice Address - Zip Code:74354-1620
Practice Address - Country:US
Practice Address - Phone:918-542-4101
Practice Address - Fax:918-542-4410
Is Sole Proprietor?:No
Enumeration Date:2021-06-29
Last Update Date:2021-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2355S0801X
OKSLPA2392355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant