Kaydra Lynee Brannan, M.S. SLP INTERN
Individual provider Active NPI Speech-Language Pathologist · Azle, TX
NPI 1124501788 · NPPES record last updated Sep 10, 2018
Key facts
- NPI
- 1124501788
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 114428 (TX)
- Practice address
- 721 Dunaway LN
Azle, TX 76020-2605 - Phone
- (682) 583-6241
- NPI assigned
- Sep 10, 2018
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Science
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist |
235Z00000X | 114428 | TX | Yes |
Addresses
Primary practice location
721 Dunaway LN
Azle, TX 76020-2605
Mailing address
1133 Boyd Rd Apt 2107
Azle, TX 76020-1252
Phone (682) 583-6241
Other providers in Azle, TX
- BLDL Industries
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- Machele L Bovea
- Brace Chiropractic and Wellness Center LLC
- Jessica Polk Brace
- Evelyn Break
- Bridge & Associates PLLC
- Britton Bronson-Rodriguez
- Kathleen Lawlor Brooks
- Brookshire Grocery Company
All providers in Azle, TX · Speech-Language Pathologist in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 10, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.