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General NPI Number Information
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NPI Number | 1386010585
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Entity Type | Individual
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Provider Name | ANIKKA BRILL
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Gender | Female
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Dates
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Enumeration Date | 08/11/2015
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Last Update Date | 08/11/2015
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Provider Practice Location Address
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Address Line | 171 WESTVIEW DR
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City | ELIZABETHTOWN
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State | PA
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Zip | 17022-9459
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Country | US
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Telephone | 717-371-6865
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Fax |
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Provider Business Mailing Address
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Address Line | 171 WESTVIEW DR
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City | ELIZABETHTOWN
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State | PA
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Zip | 17022-9459
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Country | US
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Telephone | 717-371-6865
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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 | SL012290
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License Number State | PA
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