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NPI Code Detail

MEDICARE: BROOKE PRESTON

MEDICARE: BROOKE PRESTON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist2742AL

General Provider Information

NPI Number : 1013792803
Entity Type Code : Individual
Provider Name (Legal Business Name) : BROOKE PRESTON
Provider Business Mailing Address
First Line : 3775 ROSS CLARK CIR
Second Line :
City : DOTHAN
State : AL
Zip : 36303-2251
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3775 ROSS CLARK CIR
Second Line :
City : DOTHAN
State : AL
Zip : 36303-2251
Country : US
Telephone Number : 334-316-0191
Fax Number : 334-625-1852
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/29/2023
Last Update Date : 08/29/2023

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Directions to “ BROOKE PRESTON ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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