Brittany Prevallet, MA, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SLP6954 Issued in AZ

Practice address

3576 Kearsage Dr
Lake Havasu City, AZ 86406-9115

Phone

(928) 453-1500

NPI assigned

May 15, 2012

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1337040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337040000000",
    "number": "1295094837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1715 LOS LAGOS DR",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864036648",
            "telephone_number": "573-768-1752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3576 KEARSAGE DR",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864069115",
            "telephone_number": "928-453-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PREVALLET",
        "first_name": "BRITTANY",
        "name_prefix": "Miss",
        "credential": "MA, CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-15",
        "last_updated": "2012-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AZ",
            "license": "SLP6954",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rajitha L Premaratne, M.D.
• Prescott Vamc
• Edward Jonathan Presser, PT, DPT
• Prestige Assisted Living at Claremont
• Michele Ann Preston, D.O
• Prima Medical Care LLC
• Progressive Rehabilitation Orthopedic Therapy, Inc
• Pulmonary Associates of Northwestern Arizona, PLLC
• Brett Qualls, PT
• Edward J Quinn, MD

• Speech-Language Pathologist in Lake Havasu City, AZ
• Providers in Lake Havasu City, AZ by specialty
• Speech-Language Pathologist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.