MEDICARE: BROOKE JONES

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	235Z00000X	Speech-Language Pathologist	3171960	ID
2	2355S0801X	Speech-Language Assistant	5010	CA
3	235Z00000X	Speech-Language Pathologist	33780	CA
4	235Z00000X	Speech-Language Pathologist	16014	CA

General Provider Information

NPI Number	:	1457832792
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BROOKE JONES

Provider Business Mailing Address
First Line	:	3815 N SCHREIBER WAY UNIT 103
Second Line	:
City	:	COEUR D ALENE
State	:	ID
Zip	:	83815-8434
Country	:	US
Telephone Number	:	208-518-6551
Fax Number	:

Provider Business Practice Location Address
First Line	:	3815 N SCHREIBER WAY UNIT 103
Second Line	:
City	:	COEUR D ALENE
State	:	ID
Zip	:	83815-8434
Country	:	US
Telephone Number	:	208-518-6551
Fax Number	:

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

Provider Enumeration Date	:	08/24/2018
Last Update Date	:	11/11/2025

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Directions to “ BROOKE JONES ” Practice Location

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