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General NPI Number Information
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NPI Number | 1902653520
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Entity Type | Individual
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Provider Name | BREAH RAPP MS
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Gender | Female
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Dates
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Enumeration Date | 05/01/2024
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Last Update Date | 05/28/2024
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Provider Practice Location Address
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Address Line | 1903 UNION ST
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City | LAFAYETTE
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State | IN
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Zip | 47904-2627
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Country | US
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Telephone | 765-588-5615
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Fax |
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Provider Business Mailing Address
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Address Line | 3130 COURTHOUSE DR E APT 1A
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City | WEST LAFAYETTE
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State | IN
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Zip | 47906-1018
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Country | US
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Telephone | 469-237-0695
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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 | 46004390A
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License Number State | IN
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