Brooke Richardson, MA, CCC-SLP
Speech-Language Pathologist, in Gouverneur, NY. Individual provider (NPI-1).
NPI number1609597657
StatusActive
Last updated in NPPESSep 8, 2022
Details
- NPI
- 1609597657
- Entity type
- Individual (NPI-1)
- Name
- Brooke Richardson
- Credential
- MA, CCC-SLP
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Sep 8, 2022
- Certification date
- Sep 8, 2022
- Last updated
- Sep 8, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 235Z00000X | Speech-Language Pathologist, | 031958 | NY | Yes |
Practice location
111 Gleason StGouverneur, NY 13642-1217
Phone 315-528-8740
Mailing address
287 Dennis RdLisbon, NY 13658-4219
Phone 315-528-5870
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