MEDICARE: ERIKA HAYLEY BRACE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	010837	NY

General Provider Information

NPI Number	:	1194755298
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIKA HAYLEY BRACE

Provider Business Mailing Address
First Line	:	26 TREE TOP LANE
Second Line	:
City	:	WEST HENRIETTA
State	:	NY
Zip	:	14586-9531
Country	:	US
Telephone Number	:	585-727-2943
Fax Number	:

Provider Business Practice Location Address
First Line	:	26 TREE TOP LANE
Second Line	:
City	:	WEST HENRIETTA
State	:	NY
Zip	:	14586-9531
Country	:	US
Telephone Number	:	585-727-2943
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/04/2006
Last Update Date	:	03/21/2013

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Directions to “ ERIKA HAYLEY BRACE ” Practice Location

Language	Start Address	Practice Location

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