Healthcare Provider Details
I. General information
NPI: 1770012833
Provider Name (Legal Business Name): BRITTANY LYNN DEUR M.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/12/2017
Last Update Date: 03/26/2021
Certification Date: 03/26/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7150 KALAMAZOO AVE SE STE B
CALEDONIA MI
49316-9197
US
IV. Provider business mailing address
5060 CASCADE RD SE STE A
GRAND RAPIDS MI
49546-3808
US
V. Phone/Fax
- Phone: 616-333-1800
- Fax: 616-803-5323
- Phone: 616-333-1800
- Fax: 616-803-5323
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 235Z00000X |
| Taxonomy | Speech-Language Pathologist |
| License Number | 7101005342 |
| License Number State | MI |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: