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General NPI Number Information
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NPI Number | 1861064651
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Entity Type | Individual
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Provider Name | BROOKE BERTRAND MS
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Gender | Female
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Dates
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Enumeration Date | 07/12/2021
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Last Update Date | 03/30/2025
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Provider Practice Location Address
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Address Line | 730 IRENE ST
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City | KIMBERLY
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State | ID
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Zip | 83341-2047
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Country | US
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Telephone | 208-420-8623
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Fax |
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Provider Business Mailing Address
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Address Line | 929 DEL MAR CIR
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City | TWIN FALLS
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State | ID
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Zip | 83301-6718
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Country | US
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Telephone | 208-420-8623
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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 |
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License Number State |
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