Provider Demographics
NPI:1225824212
Name:BRUMLEY, BROOKLYNE N
Entity type:Individual
Prefix:
First Name:BROOKLYNE
Middle Name:N
Last Name:BRUMLEY
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 GOLDEN EAGLE TRL
Mailing Address - Street 2:
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31093-1166
Mailing Address - Country:US
Mailing Address - Phone:405-543-8279
Mailing Address - Fax:
Practice Address - Street 1:400 SE 2ND ST
Practice Address - Street 2:
Practice Address - City:BLANCHARD
Practice Address - State:OK
Practice Address - Zip Code:73010-5529
Practice Address - Country:US
Practice Address - Phone:405-779-3270
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-16
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKSLPA3712355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant