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General NPI Number Information
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NPI Number | 1942935093
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Entity Type | Individual
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Provider Name | BRIANA POPOLO CCC-CLP
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Gender | Female
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Dates
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Enumeration Date | 07/22/2022
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Last Update Date | 07/22/2022
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Provider Practice Location Address
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Address Line | 168 FRANKLIN CORNER RD BLDG 1
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City | LAWRENCEVILLE
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State | NJ
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Zip | 08648-2529
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Country | US
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Telephone | 609-299-1279
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Fax | 609-357-4028
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Provider Business Mailing Address
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Address Line | PO BOX 416495
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City | BOSTON
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State | MA
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Zip | 02241-6495
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Country | US
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Telephone | 914-294-4050
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Fax | 631-760-8306
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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 | 41YS01100600
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License Number State | NJ
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