MEDICARE: JAMIE BROOKS-NOWAK MS, 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
1	235Z00000X	Speech-Language Pathologist	144.0134307	VT

General Provider Information

NPI Number	:	1770094781
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMIE BROOKS-NOWAK MS, CCC-SLP

Provider Business Mailing Address
First Line	:	174 HIGH ST
Second Line	:
City	:	SAINT ALBANS
State	:	VT
Zip	:	05478-1580
Country	:	US
Telephone Number	:	716-597-8353
Fax Number	:

Provider Business Practice Location Address
First Line	:	174 HIGH ST
Second Line	:
City	:	SAINT ALBANS
State	:	VT
Zip	:	05478-1580
Country	:	US
Telephone Number	:	716-597-8353
Fax Number	:

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

Provider Enumeration Date	:	10/17/2017
Last Update Date	:	12/03/2024

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Directions to “ JAMIE BROOKS-NOWAK MS, CCC-SLP” Practice Location

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