MEDICARE: BROOKE LOWELL SMITH M.S. CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist

General Provider Information

NPI Number	:	1255624771
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BROOKE LOWELL SMITH M.S. CCC-SLP

Provider Business Mailing Address
First Line	:	1117 S DOUGLAS BLVD STE F
Second Line	:
City	:	MIDWEST CITY
State	:	OK
Zip	:	73130-5265
Country	:	US
Telephone Number	:	405-259-9478
Fax Number	:	405-259-8332

Provider Business Practice Location Address
First Line	:	1117 S DOUGLAS BLVD STE F
Second Line	:
City	:	MIDWEST CITY
State	:	OK
Zip	:	73130-5265
Country	:	US
Telephone Number	:	405-259-9478
Fax Number	:	405-259-8332

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/17/2011
Last Update Date	:	06/01/2026

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Directions to “ BROOKE LOWELL SMITH M.S. CCC-SLP” Practice Location

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