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NPI Code Detail

MEDICARE: JESSICA MARIE BRIENZA

MEDICARE:   JESSICA MARIE BRIENZA
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
1235Z00000XSpeech-Language PathologistSP10560OH

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2AB7360731OTHERMEDICARE PIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1699295097
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA MARIE BRIENZA
Provider Business Mailing Address
First Line : 7591 TYLERS PLACE BLVD
Second Line :
City : WEST CHESTER
State : OH
Zip : 45069-6308
Country : US
Telephone Number : 513-755-6600
Fax Number : 513-755-3762
Provider Business Practice Location Address
First Line : 3817 COLONEL GLENN HWY
Second Line :
City : BEAVERCREEK
State : OH
Zip : 45324-2031
Country : US
Telephone Number : 937-427-9200
Fax Number : 513-755-3762
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/27/2017
Last Update Date : 06/27/2017

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Directions to “ JESSICA MARIE BRIENZA ” Practice Location

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