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General NPI Number Information
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NPI Number | 1306098660
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Entity Type | Individual
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Provider Name | BROOKE ELIZABETH CRENSHAW M.S., CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 10/17/2008
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Last Update Date | 07/09/2012
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Provider Practice Location Address
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Address Line | 1508 2ND AVE SW
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City | ROCHESTER
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State | MN
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Zip | 55902-2114
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Country | US
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Telephone | 312-513-5120
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Fax |
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Provider Business Mailing Address
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Address Line | 1508 2ND AVE SW
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City | ROCHESTER
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State | MN
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Zip | 55902-2114
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Country | US
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Telephone | 312-513-5120
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 146-008493
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 8885
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License Number State | MN
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