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NPI Code Detail

MEDICARE: BROOKE A ADOLFF CCC-SLP

MEDICARE:   BROOKE A ADOLFF  CCC-SLP
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 Pathologist9210NC

General Provider Information

NPI Number : 1588825897
Entity Type Code : Individual
Provider Name (Legal Business Name) : BROOKE A ADOLFF CCC-SLP
Provider Business Mailing Address
First Line : 4477 REDFERN PL
Second Line :
City : WINSTON SALEM
State : NC
Zip : 27107-3807
Country : US
Telephone Number : 330-301-0750
Fax Number :
Provider Business Practice Location Address
First Line : 877 HILL EVERHART RD
Second Line :
City : LEXINGTON
State : NC
Zip : 27295-9140
Country : US
Telephone Number : 336-248-6644
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/19/2008
Last Update Date : 09/04/2013

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Directions to “ BROOKE A ADOLFF CCC-SLP” Practice Location

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