Individual
KELLY BROOKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
67 S HIGLEY RD STE 103-477, GILBERT, AZ 85296-1166
(314) 456-1880
Mailing address
749 WOODRUN DR, BALLWIN, MO 63021-6173
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2018016959
MO
Other
Enumeration date
08/13/2018
Last updated
01/15/2024
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