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Individual
MS. BROOKE INGRAM
Active
Individual
MS. BROOKE INGRAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
S.I.
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
—
—
2355S0801X
Speech-Language Assistant
SI1381
FL
235Z00000X
Speech-Language Pathologist
Primary
SA11282
FL
235Z00000X
Speech-Language Pathologist
SZ5188
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001476500
—
FL
05
—
002805400
—
FL
Enumeration date
06/28/2007
Last updated
11/29/2011
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