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General NPI Number Information
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NPI Number | 1770105140
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Entity Type | Individual
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Provider Name | BROOKLYN SPARNECHT SLP
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Gender | Female
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Dates
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Enumeration Date | 05/08/2020
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Last Update Date | 06/10/2025
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Provider Practice Location Address
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Address Line | 5726 BLACKJACK RD
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City | STARKVILLE
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State | MS
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Zip | 39759-5325
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Country | US
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Telephone | 662-322-4729
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Fax | 662-350-7099
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Provider Business Mailing Address
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Address Line | 115 METTS ST
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City | LOUISVILLE
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State | MS
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Zip | 39339-2601
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Country | US
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Telephone | 662-736-0670
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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 | S4606
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License Number State | MS
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