MEDICARE: MARIA ANNA BRANDON MS, CCC-SLP

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	016287	NY
2	235Z00000X	Speech-Language Pathologist	1250	NV

General Provider Information

NPI Number	:	1871633495
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA ANNA BRANDON MS, CCC-SLP

Provider Business Mailing Address
First Line	:	7707 LONE SHEPHERD DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89166-5119
Country	:	US
Telephone Number	:	631-796-8224
Fax Number	:

Provider Business Practice Location Address
First Line	:	7707 LONE SHEPHERD DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89166-5119
Country	:	US
Telephone Number	:	631-796-8224
Fax Number	:

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

Provider Enumeration Date	:	02/07/2007
Last Update Date	:	07/23/2022

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