Healthcare Provider Details

I. General information

NPI: 1922588524
Provider Name (Legal Business Name): BRITTNEY OBY SLP-A
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/14/2018
Last Update Date: 08/14/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4545 COOK RD
HOUSTON TX
77072-1131
US

IV. Provider business mailing address

2277 WINROCK BLVD APT 124
HOUSTON TX
77057-4013
US

V. Phone/Fax

Practice location:
  • Phone: 225-485-5016
  • Fax:
Mailing address:
  • Phone: 225-485-5016
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number39027
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: