Individual
JACQUELINE BROOKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.ED., CCC-SLP
Contact information
Practice address
7902 CROSSHILL CT, FORT WAYNE, IN 46825-3191
(260) 615-3966
Mailing address
7902 CROSSHILL CT, FORT WAYNE, IN 46825-3191
(260) 615-3966
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
22002084A
IN
Other
Enumeration date
07/10/2017
Last updated
07/21/2022
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