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General NPI Number Information
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NPI Number | 1275033813
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Entity Type | Individual
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Provider Name | BROOKLYNN KAY PINKHAM
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Gender | Female
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Dates
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Enumeration Date | 02/20/2018
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Last Update Date | 02/20/2018
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Provider Practice Location Address
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Address Line | 2400 WESTPORT PKWY STE 1300
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City | FORT WORTH
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State | TX
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Zip | 76177-5316
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Country | US
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Telephone | 817-773-6841
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Fax |
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Provider Business Mailing Address
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Address Line | 401 NORTHWEST HWY APT 1108
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City | IRVING
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State | TX
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Zip | 75039-3682
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Country | US
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Telephone | 903-280-8383
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2355S0801X
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Taxonomy Name | Speech-Language Assistant
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License Number | 38481
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License Number State | TX
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