Emily Claire Brokens, MS CCC-SLP

Individual provider Active NPI Speech-Language Pathologist · Farmington, NM

NPI 1487903944 · NPPES record last updated Feb 20, 2024

Key facts

NPI
1487903944
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
3715-154 (WI)
Practice address
3401 E 30TH St
Farmington, NM 87402-8805
Phone
(414) 581-6250
NPI assigned
Aug 30, 2012
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
074630IAMDSpeech-Language Pathologist
146016072ILMDSpeech-Language Pathologist
SAH-2023-0033NMMDSpeech-Language Pathologist
3715-154WIMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SAH-2023-0033 NM
Speech-Language Pathologist 235Z00000X 074630 IA
Speech-Language Pathologist 235Z00000X 146016072 IL
Speech-Language Pathologist 235Z00000X 3715-154 WI Yes

Addresses

Primary practice location

3401 E 30TH St
Farmington, NM 87402-8805

Mailing address

9128 Pheasant LN
Dubuque, IA 52003-9268
Phone (414) 581-6250

Other providers in Farmington, NM

All providers in Farmington, NM · Speech-Language Pathologist in New Mexico

Sources for this page

Verify at the official NPI Registry.