Individual
MRS. CHANTELLE BROCKWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.ED., CCC-SLP
Contact information
Practice address
830 HAYLOFT LN, FOUNTAIN, CO 80817-4180
(719) 382-8571
(719) 382-8571
Mailing address
830 HAYLOFT LN, FOUNTAIN, CO 80817-4180
(719) 382-8571
(719) 382-8571
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
12034960
CO
Other
Enumeration date
11/27/2006
Last updated
07/08/2007
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