MEDICARE: BREANNA WEBSTER

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	SLP.0006222	CO

General Provider Information

NPI Number	:	1992576755
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BREANNA WEBSTER

Provider Business Mailing Address
First Line	:	2140 HOLLOW BROOK DR STE 100
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80918-1489
Country	:	US
Telephone Number	:	719-301-0218
Fax Number	:	719-931-5579

Provider Business Practice Location Address
First Line	:	2140 HOLLOW BROOK DR STE 100
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80918-1489
Country	:	US
Telephone Number	:	719-301-0218
Fax Number	:	719-931-5579

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

Provider Enumeration Date	:	01/10/2024
Last Update Date	:	11/20/2025

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Directions to “ BREANNA WEBSTER ” Practice Location

Language	Start Address	Practice Location

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