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General NPI Number Information
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NPI Number | 1750678504
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Entity Type | Individual
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Provider Name | KRISTEN ANN BRENCE MS, CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 06/30/2011
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Last Update Date | 10/08/2013
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Provider Practice Location Address
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Address Line | 1500 OXFORD DR SUITE 10
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City | BETHEL PARK
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State | PA
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Zip | 15102-1823
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Country | US
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Telephone | 412-692-3436
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Fax | 412-851-1750
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Provider Business Mailing Address
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Address Line | 1500 OXFORD DR SUITE 10
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City | BETHEL PARK
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State | PA
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Zip | 15102-1823
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Country | US
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Telephone | 412-692-3436
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Fax | 412-851-1750
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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 | SL009618
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License Number State | PA
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