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General NPI Number Information
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NPI Number | 1699079970
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Entity Type | Organization
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Legal Business Name | SHELLEY BRANDT INC
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Dates
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Enumeration Date | 12/31/2010
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Last Update Date | 12/31/2010
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Provider Practice Location Address
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Address Line | 11911 US HIGHWAY 1 SUITE 102
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City | NORTH PALM BEACH
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State | FL
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Zip | 33408-2827
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Country | US
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Telephone | 561-694-7661
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Fax | 561-694-7691
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Provider Business Mailing Address
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Address Line | 1860 KATHY LN
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City | NORTH PALM BEACH
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State | FL
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Zip | 33408-3017
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Country | US
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Telephone | 561-694-7661
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Fax | 561-694-7691
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Authorized Official
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Title or Position | OWNER/SPEECH-LANGUAGE PATHOLOGIST
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Name | SHELLEY BRANDT
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Credential | M.S. CCC-SLP
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Telephone | 561-694-7661
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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 | SA 8704
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License Number State | FL
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