Ingram, Brooke

Ingram, Brooke is an individual health care provider with primary practice located at 602 Vonderburg Dr Suite 201, Brandon FL 33511-5900. She recently has 3 registered licenses in different health care specialties including Speech, Language and Hearing Service Providers / Speech-Language Pathologist, Speech, Language and Hearing Service Providers / Speech-Language Assistant, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Developmental Therapist. Speech, Language and Hearing Service Providers / Speech-Language Pathologist is her primary health care specialty. Ingram, Brooke can be contacted via phone (813) 653-1149.

Contact Information

Primary practice address
602 Vonderburg Dr Suite 201 Brandon FL 33511-5900
Phone: (813) 653-1149
Fax: (813) 654-6644
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X SA11282 Florida
Speech, Language and Hearing Service Providers / Speech-Language Assistant 2355S0801X SI1381 Florida
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Developmental Therapist 222Q00000X
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X SZ5188 Florida

Profile Details

NPI number 1083811608
LBN Legal business name Ingram, Brooke
Credentials S.I.
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 28th, 2007
Last updated Nov 29th, 2011 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1083811608 NPPES
Florida MEDICAID 002805400
Florida MEDICAID 001476500

Popular Providers