Individual
BROOKE MARIE NGUYEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S. CCC-SLP
Contact information
Practice address
2103 N VETERANS PKWY, BLOOMINGTON, IL 61704-0908
(309) 948-6469
Mailing address
PO BOX 416501, BOSTON, MA 02241-7594
(309) 948-6469
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
242.005723
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
242.005723
—
IL
Enumeration date
08/28/2020
Last updated
04/28/2022
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