Healthcare Provider Details

I. General information

NPI: 1154284909
Provider Name (Legal Business Name): BRIANA M GILBERT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/08/2025
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

51 N MAIN ST
WEST HARTFORD CT
06107-1940
US

IV. Provider business mailing address

124 CLINT ELDREDGE RD
WILLINGTON CT
06279-1703
US

V. Phone/Fax

Practice location:
  • Phone: 860-523-9790
  • Fax:
Mailing address:
  • Phone: 860-576-1204
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number18.008155
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: