Provider Demographics
NPI:1235308156
Name:PECCIA, BROOKE HAMMOND (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:BROOKE
Middle Name:HAMMOND
Last Name:PECCIA
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 1:208 SUNSET DR
Mailing Address - Street 2:SUITE 367
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37604-2517
Mailing Address - Country:US
Mailing Address - Phone:423-282-1700
Mailing Address - Fax:423-282-9319
Practice Address - Street 1:208 SUNSET DR
Practice Address - Street 2:SUITE 367
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37604-2517
Practice Address - Country:US
Practice Address - Phone:423-282-1700
Practice Address - Fax:423-282-9319
Is Sole Proprietor?:No
Enumeration Date:2008-02-25
Last Update Date:2008-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNSP 0000002635235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist