Provider Demographics
NPI:1497379234
Name:CRAIG, BROOKE ANN (AUD)
Entity type:Individual
Prefix:DR
First Name:BROOKE
Middle Name:ANN
Last Name:CRAIG
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1113 HOLLYWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:HAVERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19083-5224
Mailing Address - Country:US
Mailing Address - Phone:610-256-2251
Mailing Address - Fax:
Practice Address - Street 1:230 SUGARTOWN RD STE 10
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:PA
Practice Address - Zip Code:19087-3071
Practice Address - Country:US
Practice Address - Phone:610-688-6003
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-07
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAT006687231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist