MEDICARE: BROOKE MARTIN

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	4313	OK

General Provider Information

NPI Number	:	1871999029
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BROOKE MARTIN

Provider Business Mailing Address
First Line	:	3223 E 31ST ST
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74105-2452
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3223 E 31ST ST
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74105-2452
Country	:	US
Telephone Number	:	918-250-7093
Fax Number	:

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

Provider Enumeration Date	:	11/17/2014
Last Update Date	:	04/24/2026

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Directions to “ BROOKE MARTIN ” Practice Location

Language	Start Address	Practice Location

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