Individual
MRS. BROOKE SAREPTA HARTLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A., CCC-SLP
Contact information
Practice address
808 NORTH STREET, CODY, WY 82414-5213
(307) 527-7060
Mailing address
P.O. BOX 1191, POWELL, WY 82435
(307) 754-2864
(307) 754-9829
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP-468
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1770688871
—
WY
Enumeration date
09/12/2008
Last updated
09/12/2008
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