Individual
BROOKE CUFF BURGUILLOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1046 MONTICELLO DR, VILLA RICA, GA 30180-7801
(770) 212-0750
Mailing address
1046 MONTICELLO DR, VILLA RICA, GA 30180-7801
(770) 212-0750
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP011876
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15695481
CAQH
—
Enumeration date
09/22/2022
Last updated
01/27/2025
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