Mallory Brock
NPI 1104769579ActiveIndividual· Speech-Language Pathologist· Cookeville, TN
Speech-Language Pathologist in Cookeville, Tennessee, trained at University of South Alabama College of Medicine (class of 2023). Enrolled in Medicare as practitioner - qualified speech language pathologist.
Overview
| NPI | 1104769579 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Sole proprietor | No |
| NPI issued | Apr 10, 2026 |
| Last updated in NPPES | Apr 10, 2026 |
| Certified by provider | Apr 10, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Speech-Language Pathologist Primary | 235Z00000X | 0884 | TN |
| Speech-Language Pathologist | 235Z00000X | 6007 | AL |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Qualified Speech Language Pathologist (AL) |
|---|
Education and affiliations
| Medical school | University of South Alabama College of Medicine |
|---|---|
| Graduation year | 2023 |
| Medicare specialty | Qualified Speech Language Pathologist |
Medical group
- Encore Rehabilitation, IncBay Minette, AL · 182 clinicians
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