Provider Demographics
NPI:1801559315
Name:WOOLEVER, BROOKE ELIZABETH (MA, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:BROOKE
Middle Name:ELIZABETH
Last Name:WOOLEVER
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:MRS
Other - First Name:BROOKE
Other - Middle Name:ELIZABETH
Other - Last Name:AITKEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA, CCC-SLP
Mailing Address - Street 1:200 MEDICAL PKWY STE 260
Mailing Address - Street 2:
Mailing Address - City:LAKEWAY
Mailing Address - State:TX
Mailing Address - Zip Code:78738-1796
Mailing Address - Country:US
Mailing Address - Phone:737-237-0016
Mailing Address - Fax:737-701-5921
Practice Address - Street 1:200 MEDICAL PKWY STE 260
Practice Address - Street 2:
Practice Address - City:LAKEWAY
Practice Address - State:TX
Practice Address - Zip Code:78738-1796
Practice Address - Country:US
Practice Address - Phone:737-237-0016
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-21
Last Update Date:2021-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX119019235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist