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NPI Code Detail

MEDICARE: BROOKS J HAZELTON CCC/SLP

MEDICARE: BROOKS J HAZELTON 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
1235Z00000XSpeech-Language Pathologist7021NC

General Provider Information

NPI Number : 1518919042
Entity Type Code : Individual
Provider Name (Legal Business Name) : BROOKS J HAZELTON CCC/SLP
Provider Business Mailing Address
First Line : 700B CROMWELL DR
Second Line :
City : GREENVILLE
State : NC
Zip : 27858-5852
Country : US
Telephone Number : 252-756-3099
Fax Number :
Provider Business Practice Location Address
First Line : 700B CROMWELL DR
Second Line :
City : GREENVILLE
State : NC
Zip : 27858-5852
Country : US
Telephone Number : 252-756-3099
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/16/2006
Last Update Date : 03/25/2014

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Directions to “ BROOKS J HAZELTON CCC/SLP” Practice Location

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