Healthcare Provider Details

I. General information

NPI: 1306755665
Provider Name (Legal Business Name): BREANNA DUNNEM MA.,CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

138 MAPLE VALLEY ST
SANDUSKY MI
48471-1504
US

IV. Provider business mailing address

138 MAPLE VALLEY ST
SANDUSKY MI
48471-1504
US

V. Phone/Fax

Practice location:
  • Phone: 810-648-9020
  • Fax: 810-648-4984
Mailing address:
  • Phone: 810-648-9020
  • Fax: 810-648-4984

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number7701007307
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: