Provider Demographics
NPI:1407006794
Name:BROOKER, JANET (BA, SLP/A)
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:
Last Name:BROOKER
Suffix:
Gender:F
Credentials:BA, SLP/A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1510 LISBON RD
Mailing Address - Street 2:
Mailing Address - City:SMACKOVER
Mailing Address - State:AR
Mailing Address - Zip Code:71762-9738
Mailing Address - Country:US
Mailing Address - Phone:870-725-3132
Mailing Address - Fax:
Practice Address - Street 1:1510 LISBON RD
Practice Address - Street 2:
Practice Address - City:SMACKOVER
Practice Address - State:AR
Practice Address - Zip Code:71762-9738
Practice Address - Country:US
Practice Address - Phone:870-725-3132
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-24
Last Update Date:2008-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR03-00502355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant