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General NPI Number Information
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NPI Number | 1780008417
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Entity Type | Organization
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Legal Business Name | STEFANIE BRANNAN M.S. CCC-SLP
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Dates
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Enumeration Date | 02/17/2014
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Last Update Date | 02/17/2014
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Provider Practice Location Address
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Address Line | 4940 SAN DIEGO CT
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City | SPARKS
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State | NV
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Zip | 89436-0687
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Country | US
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Telephone | 775-742-8635
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Fax | 775-448-6106
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Provider Business Mailing Address
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Address Line | 4940 SAN DIEGO CT
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City | SPARKS
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State | NV
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Zip | 89436-0687
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Country | US
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Telephone | 775-742-8635
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Fax | 775-448-6106
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Authorized Official
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Title or Position | OWNER/SPEECH LANGUAGE PATHOLOGIST
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Name | STEFANIE BRANNAN
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Credential | M.S. CCC-SLP
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Telephone | 775-742-8635
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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 | SP-1216
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License Number State | NV
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