Individual
MS. BEATA MARIANNA BROOKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCC/SLP
Contact information
Practice address
2205 HURLEY AVE, FORT WORTH, TX 76110-1829
(817) 888-0422
(817) 924-7658
Mailing address
2205 HURLEY AVE, FORT WORTH, TX 76110-1829
(817) 888-0442
(817) 924-7658
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
104475
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
208626601
—
TX
01
—
805T852
BLUE CROSS BLUE SHIELD
TX
Enumeration date
12/07/2009
Last updated
08/16/2013
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