MEDICARE: BROOKE TAYLOR ALLEN BS SLPA

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
1	2355S0801X	Speech-Language Assistant	SLPA15426	AZ

General Provider Information

NPI Number	:	1063363083
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BROOKE TAYLOR ALLEN BS SLPA

Provider Business Mailing Address
First Line	:	12055 W WESTLAND RD UNIT 1068
Second Line	:
City	:	PEORIA
State	:	AZ
Zip	:	85383-6491
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7070 W HEATHERBRAE DR
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85033-2699
Country	:	US
Telephone Number	:	623-691-3900
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/05/2026
Last Update Date	:	02/05/2026

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