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General NPI Number Information
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NPI Number | 1578451233
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Entity Type | Individual
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Provider Name | BROOKELYN KAY REIL AUD
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Gender | Female
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Dates
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Enumeration Date | 06/24/2025
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Last Update Date | 06/24/2025
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Provider Practice Location Address
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Address Line | 3945 WASHINGTON BLVD STE 1
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City | OGDEN
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State | UT
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Zip | 84403-1988
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Country | US
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Telephone | 801-479-4105
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Fax |
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Provider Business Mailing Address
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Address Line | 1531 S GREEN ST APT 1
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City | SALT LAKE CITY
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State | UT
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Zip | 84105-2130
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Country | US
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Telephone | 702-245-9531
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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 | 14228809-4101
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License Number State | UT
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