Doctor Name: | BREANNA R NELSON |
NPI Number: | 1942260401 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S. |
License Number: | 2202004803 |
Business Practice Address: | 2150 Balboa Way Unit 11 St George, UT - 847708720 |
Business Phone Number: | 7032179331 |
Business Fax Number: | |
Mailing Address: | 2150 Balboa Way Unit 11, ST GEORGE |
State: | UT |
Postal Code: | 847708720 |
Phone Number: | 7032179331 |
Fax Number: | |
NPI Enumeration Date: | 03/27/2006 |
NPI Last Update Date: | 07/10/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 2202004803 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VA |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |