=====================================================
General NPI Number Information
=====================================================
NPI Number | 1366363376
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DESIREE MARIE BRESTER M.S. CCC-SLP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/24/2026
-----------------------------------------------------
Last Update Date | 07/24/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3445 BLACKBIRD DR APT 11
-----------------------------------------------------
City | BOZEMAN
-----------------------------------------------------
State | MT
-----------------------------------------------------
Zip | 59718-8241
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 541-743-5851
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3445 BLACKBIRD DR APT 11
-----------------------------------------------------
City | BOZEMAN
-----------------------------------------------------
State | MT
-----------------------------------------------------
Zip | 59718-8241
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 541-743-5851
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 235Z00000X
-----------------------------------------------------
Taxonomy Name | Speech-Language Pathologist
-----------------------------------------------------
License Number | PRD-SP-LIC-9669
-----------------------------------------------------
License Number State | MT
-----------------------------------------------------