Healthcare Provider Details

I. General information

NPI: 1285324103
Provider Name (Legal Business Name): BROOKE ALISON KUZA M.S., CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: BROOKE ALISON ASHLEY M.S., CCC-SLP

II. Dates (important events)

Enumeration Date: 05/12/2023
Last Update Date: 09/08/2025
Certification Date: 09/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 W AUSTIN ST
CROCKETT TX
75835-3620
US

IV. Provider business mailing address

3395 FM 2663
CROCKETT TX
75835-6148
US

V. Phone/Fax

Practice location:
  • Phone: 936-544-2125
  • Fax:
Mailing address:
  • Phone: 936-222-6326
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number118161
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: