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General NPI Number Information
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NPI Number | 1316401540
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Entity Type | Individual
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Provider Name | BRENNA OUELLETTE M.S. CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 01/22/2019
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Last Update Date | 07/24/2025
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Provider Practice Location Address
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Address Line | 21 LINCOLN AVE
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City | CENTRAL FALLS
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State | RI
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Zip | 02863-2012
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Country | US
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Telephone | 401-722-9998
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Fax |
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Provider Business Mailing Address
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Address Line | 1215 E TRUMAN RD
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City | KANSAS CITY
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State | MO
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Zip | 64106-3152
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Country | US
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Telephone | 816-418-5200
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 2019000889
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SP00462-P
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License Number State | RI
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