Provider Demographics
NPI:1043661937
Name:SAUVAGEAU, BROOKE ELAINE (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:BROOKE
Middle Name:ELAINE
Last Name:SAUVAGEAU
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3195 MILL ST
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-2201
Mailing Address - Country:US
Mailing Address - Phone:775-843-4728
Mailing Address - Fax:
Practice Address - Street 1:3195 MILL ST
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-2201
Practice Address - Country:US
Practice Address - Phone:775-843-4728
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-22
Last Update Date:2016-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVSP-1117235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist