Teresa C Brobeck, PH.D.

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SLP10908 Issued in AZ

Practice address

5815 W Utopia Rd
Room 358
Glendale, AZ 85308

Phone

(623) 806-7744

Fax

(623) 537-6221

NPI assigned

May 25, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Teresa C Rudkin Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1180051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587427200000",
    "number": "1073724449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5815 W UTOPIA RD",
            "address_2": "ROOM 358",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "85308",
            "telephone_number": "623-806-7744",
            "fax_number": "623-537-6221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5815 W UTOPIA RD",
            "address_2": "ROOM 358",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "85308",
            "telephone_number": "623-806-7744",
            "fax_number": "623-537-6221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROBECK",
        "first_name": "TERESA",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-25",
        "last_updated": "2020-04-21",
        "certification_date": "2020-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NM",
            "license": "3371",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AZ",
            "license": "SLP10908",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TERESA",
            "last_name": "RUDKIN",
            "middle_name": "C",
            "credential": "M.A.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Carlomagno Calderon Briones, MD
• Wendy Lynn Brishke, LCSW
• Yadira Brito
• Matthew Cale Britton
• Emily Bro
• Robert Broberg, RPH
• Anthony R Brock, D.M.D
• Austin Michael Brock, DMD
• Danielle Brock, PHARMD
• Myles Brockelman

• Speech-Language Pathologist in Glendale, AZ
• Providers in Glendale, AZ by specialty
• Speech-Language Pathologist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.