Provider Demographics
NPI:1033932512
Name:SVATOS, BROOKLYNN JANEA
Entity type:Individual
Prefix:
First Name:BROOKLYNN
Middle Name:JANEA
Last Name:SVATOS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:213 E GLENWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44310-8745
Mailing Address - Country:US
Mailing Address - Phone:330-996-2222
Mailing Address - Fax:
Practice Address - Street 1:213 E GLENWOOD AVE
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44310
Practice Address - Country:US
Practice Address - Phone:330-996-2222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-04
Last Update Date:2024-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPS.005676175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist