MEDICARE: JENALI M BRICHER M.ED., CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	OH3197420	OH
2	235Z00000X	Speech-Language Pathologist	SP-2053	NV

General Provider Information

NPI Number	:	1568864486
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENALI M BRICHER M.ED., CCC-SLP

Provider Business Mailing Address
First Line	:	8705 NAUTICAL BAY LN
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-3502
Country	:	US
Telephone Number	:	614-886-1219
Fax Number	:

Provider Business Practice Location Address
First Line	:	8705 NAUTICAL BAY LN
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-3502
Country	:	US
Telephone Number	:	614-886-1219
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/23/2014
Last Update Date	:	12/03/2024

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Directions to “ JENALI M BRICHER M.ED., CCC-SLP” Practice Location

Language	Start Address	Practice Location

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