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General NPI Number Information
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NPI Number | 1538329206
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Entity Type | Individual
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Provider Name | BROOKE M MCMAHAN AUD, CNIM
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Gender | Female
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Dates
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Enumeration Date | 06/16/2008
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Last Update Date | 07/29/2020
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Provider Practice Location Address
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Address Line | 15405 DAYBRIGHT DR
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City | EDMOND
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State | OK
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Zip | 73013-9627
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Country | US
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Telephone | 405-249-1379
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Fax |
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Provider Business Mailing Address
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Address Line | 15405 DAYBRIGHT DR
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City | EDMOND
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State | OK
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Zip | 73013-9627
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Country | US
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Telephone | 405-249-1379
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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 | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 359
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 246ZE0500X
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Taxonomy Name | EEG Specialist/Technologist
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License Number |
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License Number State |
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